Premiums - Nationally, on average, GEHA dental premiums have reduced slightly for the 2021 plan year. Subscribers in certain geographic areas will see a premium increase to more accurately reflect the cost of services for those areas.
Changes for High Option only – D1110 Prophylaxis - adult - Limited to twice per Calendar Year (or three if considered medically necessary for members with certain health conditions such as pregnancy, diabetes, heart disease, etc.)
We added the following procedure codes:
D0340 2D Cephalometric radiographic image - acquisition, measurement and analysis - Limited to once per lifetime.
D0350 2D Oral/facial photographic image obtained intra-orally or extra-orally - Limited once per lifetime.
D0351 3D photographic image
D0470 Diagnostic casts - Limited to once per lifetime in conjunction with an ortho case and/or prior to treatment.
D1321 Counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use - once per lifetime.
D1353 Sealant Repair - per tooth - Limited to once per tooth, per lifetime.
D2390 Resin based composite crown - anterior - Limited to anterior primary teeth only, once per tooth, per lifetime.
D2915 Re-cement cast or prefab post and core - Limited to once per tooth, per lifetime.
D2921 Reattachment of tooth fragment - incisal edge or cusp - Limited to once per tooth, per lifetime.
D3471 Surgical repair of root resorption - anterior
D3472 Surgical repair of root resorption - premolar
D3473 Surgical repair of root resorption - molar
D3501 Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior
D3502 Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar
D3503 Surgical exposure of root surface without apicoectomy or repair of root resorption - molar
D4999 Periodontal procedure, unspecified by report
D5225 Maxillary partial denture - flexible base (including retentive/clasping materials, rest and teeth)
D5226 Mandibular partial denture - flexible base (including retentive/clasping materials, rest and teeth)
D6013 Surgical placement of mini implant
D6040 Subperiosteal implant
D6050 Transosseous mandibular implant
D6092 Re-cement implant / abutment supported crown
D6093 Re-cement implant / abutment supported fixed partial denture
D6102 Debridement of peri-implant defect - Limited to once per implant, per lifetime.
D6104 Bone graft at time of implant placement
D6191 Semi-precision abutment - placement
D6192 Semi-precision attachment - placement
D6613 Onlay - cast predominately base metal, three or more surfaces
*D7994 Surgical placement - zygomatic implant
D8681 Removable orthodontic retainer adjustment
D9219 Evaluation for moderate sedation/deep sedation or general anesthesia
D9311 Consultation with a medical health care professional - Limited to once per Covered Person per lifetime.
D9932 Cleaning and inspection of removable complete denture, maxillary
D9933 Cleaning and inspection of removable complete denture, mandibular
D9934 Cleaning and inspection of removable partial denture maxillary
D9935 Cleaning and inspection of removable partial denture, mandibular
D9943 Occlusal guard adjustment