Delta Dental’s allowance for orthodontic procedures includes all appliances, adjustments, insertion, removal and post-treatment stabilization (retention).
Orthodontic Treatment Claims
Be sure to include:
- Total fee (including the initial fee/down payment and monthly payment amounts)
- Banding date
- Type of appliance
- Total length of active treatment
- Brief description of the dentition, appliance and treatment
When Delta Dental is secondary in dual coverage cases, please include the primary coverage’s total liability including copayment/coinsurance percentage and the explanation of benefits (EOB).
Include the amount paid by the previous carrier on the claim.
Specialized Orthodontic Appliances
How should we submit claims for clear aligners?
Charges for clear aligners (e.g., Invisalign®, SureSmile®) should be submitted using the appropriate orthodontic procedure code (D8010-D8090). The benefit is based on the approved fee for conventional orthodontics. Any additional fee for the non-traditional method is not billable to the patient.
Note: With some DeltaCare® USA plans clear aligners are excluded treatment.