D9995 is the CDT code for live teledentistry, where the patient's location and a remote dentist connect in real time by audio and video.
- When to use: The dentist took part live over audio and video while the encounter happened, and a service such as an evaluation is also billed.
- When not to use: Records reviewed later are D9996, an office visit for observation alone is D9430, and an audio-only phone call is not D9995.
- Billing note: Bill D9995 once per patient on its own line beside the evaluation, never alone, and expect many plans to pay zero on it.
What D9995 covers
D9995 reports that a dental encounter happened live. People at the patient’s location, whether the patient alone at home or a hygienist working chairside in a school, nursing home, or mobile setting, are connected in real time to a supervising or consulting dentist elsewhere. The connection carries both audio and video, the interaction is continuous, and everyone involved can see and discuss the same thing as it happens. The dentist is present remotely while the case is in front of someone, not reading a chart afterward.
- D9995 is an adjunct, not a service. The ADA’s guidance treats teledentistry as a mode of delivery, reported alongside the clinical procedures the patient received that day. It gets its own claim line next to the evaluation and imaging lines, never in place of them.
- One teledentistry line per encounter, one per patient. Quantity on the line cannot exceed one, and only one type of teledentistry may be reported for an encounter. The ADA reports D9995 once per patient on the date of service, the same way D9410 is reported once per date of service when the dentist travels to a home or long-term care facility.
There is no CDT code for capturing, transmitting, or receiving the information itself. Those steps go in the chart note.
D9995 against the codes it gets confused with
Four codes come up here, and only two describe delivery mode.
The teledentistry pair, split on timing.
- D9995 is synchronous: live, two-way, real-time audiovisual interaction, with the remote dentist participating while the encounter happens.
- D9996 is asynchronous: records are stored and forwarded through a secure connection, and the dentist reviews them later with no live contact.
The axis is real time versus later, not video versus photographs and not office versus remote. A dentist watching a hygienist’s intraoral camera feed live and a dentist opening the same images the next morning bill two different codes.
The two codes that answer a different question.
- D9310 is a consultation, a diagnostic opinion from a dentist or physician other than the one who requested it. It describes who provided the opinion, not how the encounter was delivered. A specialist can render that opinion over a live connection, so D9310 and D9995 can appear on the same claim.
- D9430 reports a patient coming into the office during normal hours only to be observed, with no other service that day. It requires that nothing else was billable; D9995 requires that something was. Neither is a fallback for the other.
Deciding whether the encounter is a D9995
- Was there live, two-way audio and video contact during the encounter? If the dentist only saw the records afterward, the code is D9996.
- Did the dentist render a service? An oral evaluation, a diagnosis, a treatment plan. The dentist who oversees the event and completes the evaluation documents and reports the teledentistry code.
- What clinical codes are going on the claim? Usually an evaluation such as D0120, D0140, or D0170, often with imaging or photographs such as D0220, D0230, or D0350. The ADA’s real-time scenario also reports D0801, the direct 3D intraoral surface scan, alongside the assessment and photographic codes, since a remote dentist can watch a chairside scan happen. Those lines are the claim; D9995 accompanies them.
- Does the payer’s own definition fit this encounter? Some definitions assume a caregiver is with the patient. North Dakota Medicaid describes synchronous teledentistry as live interaction between the patient and at least one dental, medical, or health caregiver at one location and an overseeing dentist at another. A dentist on video with a patient alone at home fits the ADA’s description but may not fit a payer’s, so read the policy’s definition.
- Is this a dental claim? The ADA states D9995 and D9996 apply only to claims filed against a dental benefit plan. A medical plan uses a different form, different code sets, and its own instructions.
Coverage and how carriers treat it
Teledentistry coverage depends on state practice acts, state Medicaid policy, and individual plan design at once, so it varies more than most adjunctive codes. Verify per payer and per state.
The line often pays zero on purpose. Delta Dental of Minnesota considers the fees for D9995 and D9996 inclusive in overall patient management and states they are not billable to the patient, so check the contract before posting a balance. Other payers reimburse: South Dakota Medicaid pays teledentistry at the same rate as the equivalent in-person visit. Decide the posting rule for zeroed lines in advance so every account is handled the same way.
A live encounter can carry a second claim. South Dakota Medicaid pays an originating-site facility fee to enrolled dental providers, including a dental office, FQHC, RHC, or IHS facility, for hosting the patient while a covered teledentistry service is delivered from the distant site. It is billed as HCPCS Q3014 on a CMS 1500 or 837P rather than the dental claim, and rated on the physician fee schedule. Asynchronous encounters are not eligible, so here the D9995 versus D9996 decision changes the money, not just the code. Nothing extra is paid for equipment, technicians, technology, or personnel, and other kinds of sites may host an encounter without qualifying for the fee.
State programs publish closed lists of eligible services. South Dakota Medicaid names the CDT codes it covers by teledentistry, from evaluations such as D0120, D0140, D0145, and D0150 through radiographic images including D0210, D0220, D0272, and D0330, and codes off the list may not be delivered that way. North Dakota Medicaid publishes a shorter list built around evaluation and assessment codes. The two lists do not match, so keep a per-payer note of eligible codes.
Frequency is usually once per date of service. North Dakota Medicaid requires D9995 or D9996 on a teledentistry claim and reimburses it once per date of service, matching the ADA’s quantity cap of one.
Place of service is a live denial reason. The ADA instructs dentists to report POS 02 in Item 38 and to check whether the plan wants a different value. Its guide is inconsistent here: it names 02, then adds that the place of service should match what would have been reported for an in-person visit, with POS 11 for the office as its example. Start from 02 and follow the plan’s written instruction. North Dakota Medicaid uses 02 when the patient is somewhere other than home and 10 when the patient is at home, and denies anything else.
Some programs cap the encounter’s scope. South Dakota Medicaid limits reimbursement to one reading or interpretation of a diagnostic test per visit, does not separately reimburse transmission of materials, and restricts providers who primarily or only see its recipients by teledentistry to the limited oral exam.
Documentation that supports the claim
The claim line alone does not prove a live encounter took place, so the record has to.
- The platform used. South Dakota Medicaid asks for the platform name on a synchronous visit. For an auditor, that detail separates a documented video encounter from a phone call.
- Everyone involved and their role. Names and credentials of each person, including whoever was with the patient, and what each did.
- A note that the interaction was live. The ADA requires the patient record to carry the code for the type of teledentistry encounter. State plainly that the dentist participated in real time over audio and video.
- The date the procedures were delivered. The ADA’s instruction for Item 24 is the date the procedures in the encounter were performed.
- The dentist’s findings. The evaluation, diagnosis, and treatment plan, which are what a carrier auditing the claim reads.
- Licensure across state lines. The ADA points to state law, regulation, and licensure when the dentist and patient are in different states. Confirm it before the encounter, not on appeal.
What to get right in your PMS
The teledentistry line is a procedure code that has to reach the claim with no tooth attached.
- Set up D9995 and D9996 as separate procedures with a real fee. The ADA’s instruction is the full fee for the teledentistry procedure, meaning what it costs the practice to run the technology. Even when a plan bundles it, the fee has to be on the claim to be adjudicated.
- Leave the tooth fields empty. Area of the oral cavity, tooth system, tooth numbers, and tooth surface are unused on the teledentistry line. A template that forces a tooth entry will reject the claim.
- Fill in the description field. The ADA wants the line labeled by modality, synchronous or asynchronous.
- Find where your software sets Item 38. Place of service is a claim-level property on dental claims, not a procedure attribute, so it applies to every line on the submission.
- Confirm Item 56 shows the practice’s street address. The treatment location on a teledentistry claim is the dentist’s practice, not where the patient was.
For how the service lines, place of treatment, and treating-dentist blocks are filled in on the claim, see the ADA dental claim form guide.
FAQs
- What is the dental code for a live video dental visit?
- D9995. It reports synchronous teledentistry, where people at the patient's location and a supervising or consulting dentist elsewhere interact live over audiovisual technology. The store-and-forward equivalent, where records are captured and reviewed later with no live contact, is D9996. Both took effect January 1, 2018, and both are reported in addition to the codes for the services delivered on that date of service.
- Can I bill D9995 for a phone call?
- No. Synchronous teledentistry requires video as well as audio. South Dakota Medicaid states that synchronous services may not be provided via email, audio-only, or facsimile, and that audio and visual quality must be good enough for the encounter to stand in for a face-to-face visit. North Dakota Medicaid lists audio-only contact with the consulting dentist, with no visual component, as non-covered, along with examinations by email and virtual check-ins. A phone call may still be good patient care, but it is not a D9995.
- Do I bill D9995 instead of the exam code?
- No. D9995 documents the delivery mode, so it goes on its own claim line beside the codes for what was done. Delta Dental of Minnesota puts the teledentistry code on a separate line from the evaluation, D0140 in their example. Billed alone, D9995 leaves no clinical service on the claim to adjudicate. Billed instead of the evaluation, it drops the line that carries the fee, since payers that bundle teledentistry into overall patient management, as Delta Dental of Minnesota does, pay nothing on the D9995 line.
- How many times can D9995 be billed on one date of service?
- Once per patient. The ADA's guidance reports D9995 once per patient on the date of service, the same way D9410 works for a visit to a home or long-term care facility, and caps quantity on the line at one. North Dakota Medicaid reimburses D9995 or D9996 once per date of service. Only one type of teledentistry may be reported for an encounter, so D9995 and D9996 never appear together for the same visit. A mobile event covering ten residents produces ten claims, each with one D9995 line.
- Is D9995 the same as D9430, an office visit for observation?
- No; the two are close to opposites. D9430 reports an in-office visit during regular hours where nothing else was performed, so it requires that there be no other billable service. D9995 requires that there be one, since it only reports how a service reached the patient. A video check-in that produced no reportable service is not fixed by swapping in D9430, which describes an office visit that did not happen.
- Does D9995 pay anything?
- It depends on the payer, and a zero is often intended rather than a denial worth appealing. Delta Dental of Minnesota treats teledentistry fees as inclusive in overall patient management and states they are not billable to the patient, so the evaluation is the payable line. Other payers reimburse: South Dakota Medicaid pays teledentistry at the same rate as the equivalent face-to-face visit. Put a real fee on the code, expect it to zero out on many EOBs, and read the participating-provider contract before moving the balance to the patient.
Related codes
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CDT codes are maintained by the American Dental Association. This page is an editorial billing guide, not the official ADA code descriptor. Verify current coverage policies with each carrier before submitting claims.