Please be advised that procedure codes are subject to change during the plan year.
Charges for co-paid services received after your annual maximum has been reached are not covered.
|
Diagnostic and Preventive
|
| Comprehensive oral evaluation, for new or established patient, once every 5 years per provider |
| Periodic oral evaluation, once every 6 consecutive months* |
| Limited oral evaluation (no separate benefit paid for some definitive treatment if performed on the same day), three occurrences in 6 months |
Oral evaluation for a patient under 3 years of age and counseling
with primary caregiver |
| Intraoral X-rays, complete series or panorex, once every 60 months |
| Intraoral periapical X-ray |
Bitewing X-rays, once every 6 consecutive months for
dependents age 18 and under; once every 12 consecutive
months for adults* |
| Pulp vitality tests |
Adult and child prophylaxis (cleaning), once every 6 consecutive
months* |
Fluoride treatment, once every 6 consecutive months for
dependents age 18 and under* |
Topical fluoride varnish, therapeutic application, for moderate to
high caries risk patients |
Prescription strength fluoride toothpaste dispensed in the dental
office available for adult patients following certain periodontal
surgeries |
Sealant per tooth, only on unrestored permanent molars, once
every 48 months for dependents age 18 and under |
Chlorhexidine anti-bacterial mouthrinse dispensed in the dental
office for patients receiving periodontal scaling and root
planing, once every 6 months |
Space maintainers, once per lifetime, for dependents age 14 and
under |
| Re-cementation of space maintainers |
| Removal of fixed space maintainer |