New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 56 - MANUAL FOR DENTAL SERVICES
Subchapter 3 - HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS)
Section 10:56-3.11 - D8000-D8999 ORTHODONTICS
Universal Citation: NJ Admin Code 10:56-3.11
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Minor treatment for tooth guidance:
1. Includes all necessary adjustments.
2. Code may also be used for Orthodontic Retention Appliances following comprehensive treatment by a previous dentist.
| Maximum Fee | ||||||
| HCPCS | Allowance | |||||
| IND | Code | Mod | Procedure Description | S | $ | NS |
| D8010 | Limited orthodontic treatment of | 595.00 | 590.00 | |||
| the primary dentition | ||||||
| D8020 | Limited orthodontic treatment of | 595.00 | 590.00 | |||
| the transitional dentition | ||||||
| D8030 | Limited orthodontic treatment of | 595.00 | 590.00 | |||
| the adolescent dentition | ||||||
| D8040 | Limited orthodontic treatment of | 595.00 | 590.00 | |||
| the adult dentition | ||||||
| D8050 | Interceptive orthodontic treatment | 595.00 | 590.00 | |||
| of the primary dentition | ||||||
| D8060 | Interceptive orthodontic treatment | 595.00 | 590.00 | |||
| of the transitional dentition | ||||||
(b) Minor treatment to control harmful habits:
1. Includes all necessary adjustments.
| D8210 | Removable Appliance Therapy | 595.00 | 590.00 |
| D8220 | Fixed Appliance Therapy | 595.00 | 590.00 |
(c) Comprehensive orthodontic treatment--adolescent dentition:
1. Treatment of permanent dentition. Indicate anticipated time under treatment--maximum treatment reimbursable including retention--three years. Reimbursement for comprehensive orthodontic treatment will include removal and retention as required at no additional charge.
| D8080 | Comprehensive orthodontic | 2,581 | 2,581 |
| treatment of the adolescent | |||
| dentition |
(d) Other orthodontic services:
| D8660 | Pre-orthodontic treatment visit | 11.00 | 10.00 |
NOTE 1: This code is to be used for comprehensive orthodontic evaluation and assessment.
NOTE 2: Definition and Criteria for Assessing Handicapping Malocclusion Permanent Dentition form (FD-10) must be available in patient records.
| D8691 | Repair of orthodontic appliance | 49.50 | 45.00 | |
| D8692 | Replacement of lost or broken | 115.00 | 110.00 | |
| retainer | ||||
| * | D8999 | Unspecified Orthodontic Procedure, | BR | BR |
| By Report |
NOTE: Complete description, diagnosis and treatment plan must be submitted.
Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
