metlife dental fee schedule 2020 for providers

Do you want to continue? 0000037929 00000 n Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 163 0 obj <> endobj The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. m-4f'f{">H746Z5apg`u0? Choose a category below to see questions and answers about Dental Maintenance Organization (DMO) coverage. 0000044288 00000 n MetLife Vision contracted providers allow full and equal L0621014064[exp0622][All States]. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Links to various non-Aetna sites are provided for your convenience only. Applicable FARS/DFARS apply. Who can enroll in the plan? DNO (Dental Network Only) in Virginia is not an HMO. ?LkG1/p#- -vBw|4W:AB Q=,AfU3mknmwQn%z7 hbbd```b``v> >d(XM|&c0L*e$li6"A@Lg` hT After you complete a service, you file claims through the ProviderOne portal. In case of a conflict between your plan documents and this information, the plan documents will govern. This guide was discontinued July 1, 2020. Treating providers are solely responsible for medical advice and treatment of members. The PCD has primary responsibility for managing your dental care. By contacting the Payor, a provider can identify which network fee schedule is being utilized for claim reimbursement and verify participation status with the plan. For step-by-step instructions on completing a PA, visit our Prior authorization (PA) page. Periodontal maintenance is for patients whove previously had periodontal treatment. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 0 WebAll Other Dental Services You Pay $0 In-Network $50 Out-of-Network $50 The maximum amount Guardian will reimburse you for dental services received Limitations and Exclusions (see your policy for further details) We will not pay WebBoth of our dental plans include: Comprehensive dental services, from preventive care to crowns, bridges and dentures No in-network deductibles and no waiting periods, including orthodontia for children and adults Worldwide coverage with a large nationwide network. ? In Illinois, DMO plans provide limited out-of-network benefits. CPT only copyright 2015 American Medical Association. For fee schedule and rate questionsEmail:ProfessionalRates@hca.wa.gov, For all other provider questionsMedical Assistance Customer Service Center (MACSC)Online: secure formPhone: 1-800-562-3022, Website feedback: Tell us how were doing, Copyright 2023 Washington Health Care Authority, I help others apply for & access Apple Health, Apple Health for Workers with Disabilities (HWD), Medically Intensive Children's Program (MICP), Behavioral health services for prenatal, children & young adults, Wraparound with Intensive Services (WISe), Behavioral health services for American Indians & Alaska Natives (AI/AN), Substance use disorder prevention & mental health promotion, Introduction overview for general eligibility, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services & supports (LTSS) manual, Medical plans & benefits (including vision), Life, home, auto, AD&D, LTD, FSA, & DCAP benefits. Copyright 2015 by the American Society of Addiction Medicine. %%EOF You or your dentist may also call Member Services. If so, most services will be considered separately. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Benefits provided by SafeGuard Health Plans, Inc., a MetLife company. *v:G)JeU%IcRr)\%Ts6q^HpCw-yAuYxU'`ho(7;v};}%-`Fuak`Htf,i1+S|@n-2yC%\rk&(NV;*_(bH *-y;tKMJE-V4"%!GUTEj)/3R$F`}C f0]o~lb>9=Grn5+;X@:D?CwX}/fb'e[=A3[ ~m;j\ZOE%H8RsZg ~mH.l%:~EYwO-$Hcm6dqaW[dc( z hW[O8+~ 0000043626 00000 n Ah{sX+AN=SPajl}la3)GfZC^T How do I notify PEBB that my loved one has passed away? Links to various non-Aetna sites are provided for your convenience only. You can view and print your ID card from your member website. The DMO plan doesnt have any deductibles or annual maximums. It sets what they can charge for covered services. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. endstream endobj 4806 0 obj <>stream Find a dentist near endstream endobj 4797 0 obj <>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 4798 0 obj <>stream For language services, please call the number on your member ID card and request an operator. Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Aetna Dental members dont need a member ID card to get dental care. hbbd```b`` Your benefits plan determines coverage. Or call Member Services at the number on your ID card. H|y\GozfKQgxDxk5Q"E[/P# GYf>WWU]z #Fv;t|*DDG&)07"jnlM&r3fLIsg@L?2t&&:r@p>_hwxwm!1IcNp,<6nfT^IAI. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. Metropolitan Life Insurance Company, New York, NY 10166 HTn0?N$vt.taQ"]QI~}kGvc:PXJ ,DDIuEE}%uDp'QMXzm:h?cZH;%*E[*& The ABA Medical Necessity Guidedoes not constitute medical advice. Top 3 reasons to choose Aetna Dental Your choice of any licensed dentist, in or out of network, worldwide, including virtual providers 0000020858 00000 n Some problems may need more than one service to fix. $10 to $50 to extract a tooth. t|%y,$Z1/7`v||f})"h[sE\o~_z~$q-`?X \h-:tm){1U:;%j%D^TN"pX'nw]Fs3)bNiA@g4,pLk,k{s6?}J}A &\R:lf~>W1C",h+QZ{K'.52 zYtVIp`0 x{B&$M"yhZICt`0> :1r 2!iMFnAo)1%i"74/+v[0N)mgaJY[X _1d7$3H\3. rxo @ e(m#GIByY6Cs|@5'C/9GL[sN`8!@d2j This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. If you do not intend to leave our site, close this message. If so, the primary care doctor will arrange it. Discontinued 3/31/2013. 0000016913 00000 n WebJuly 1, 2022 to present Mobile anesthesia for dental services billing guide; Fee schedules. August 1, 2022 to present Neurodevelopmental centers billing guide, July 1, 2022 to July 31, 2022 Neurodevelopmental centers billing guide, July 1, 2021 to June 30, 2022 Neurodevelopmental centers billing guide, View all neurodevelopmental centers billing guides, July 1, 2022 to present Neurodevelopmental centers fee schedule, July 1, 2021 to June 30, 2022 Neurodevelopmental centers fee schedule, January 1, 2021 to June 30, 2021 Neurodevelopmental centers fee schedule, View all neurodevelopmental centers fee schedules, January 1, 2019 to March 31, 2019 Nondurable medical supplies and equipment billing guides, July 1, 2018 to December 31, 2018 Nondurable medical supplies and equipment billing guides, View all nondurable medical supplies and equipment billing guides, January 1, 2019 to March 31, 2019 Nondurable medical supplies and equipment fee schedule, April 1, 2023 to present Nursing facilities billing guide, January 1, 2023 to March 31, 2023 Nursing facilities billing guide, October 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billing guide, July 1, 2022 to July 31, 2022 Outpatient rehabilitation billing guide, January 1, 2022 to June 30, 2022 Outpatient rehabilitation billing guide, View all Outpatient Rehabilitation Program billing guides, July 1, 2022 to present Outpatient rehabilitation fee schedule, July 1, 2021 to June 30, 2022 Outpatient rehabilitation fee schedule, January 1, 2021 to June 30, 2021 Outpatient rehabilitation fee schedule, View all Outpatient Rehabilitation Program fee schedules, July 1, 2022 to present Pharmacy Special Services fee schedule, July 1, 2021 to June 30, 2022 Pharmacy Special Services fee schedule, July 1, 2020 to June 30, 2021 Pharmacy Special Services fee schedule, View all pharmacy special services fee schedules, May 1, 2023 to present - Physician-related services/health care billing guide, April 1, 2023 to April 31, 2023 Physician-related services/health care billing guide, January 1, 2023 to March 31, 2023 Physician-related services/health care billing guide, View all physician-related/professional services billing guides, April 1, 2023 to present Physician-related services fee schedule, January 1, 2023 to March 31, 2023 Physician-related services fee schedule, October 1, 2022 to December 31, 2022 Physician-related services fee schedule, View all physician-related/professional services fee schedules, January 1, 2023 to present Enhanced pediatric fee schedule, July 1, 2022 to December 31, 2022 Enhanced pediatric fee schedule, October 1, 2021 to June 30, 2022 Enhanced pediatric fee schedule, View all enhanced pediatric fee schedules, January 1, 2023 to present Enhanced adult primary care fee schedule, July 1, 2022 to December 31, 2022 Enhanced adult primary care fee schedule, October 1, 2021 to June 30, 2022 Enhanced adult primary care fee schedule, January 1, 2023 to present Opioid use disorder fee schedule, July 1, 2022 to December 31, 2022 Opioid use disorder fee schedule, July 1, 2021 to June 30, 2022 Opioid use disorder fee schedule, View all medication for opioid use disorder fee schedules, July 1, 2022 to present Conversion factors, July 1, 2021 to June 30, 2022 Conversion factors, July 1, 2020 to June 30, 2021 Conversion factors, Centers of Excellence: organ transplant facilities directory, April 1, 2023 to present Planned home births and births in centers billing guide, January 1, 2023 to March 31, 2023 Planned home births and births in centers billing guide, October 1, 2022 to December 31, 2022 Planned home births and births in centers billing guide, View all planned home births billing guides, January 1, 2023 to present Planned home births and births in centers fee schedule, July 1, 2022 to December 31, 2022 Planned home births and births in centers fee schedule, July 1, 2021 to June 30, 2022 Planned home births and births in centers fee schedule, View all planned home births fee schedules, July 1, 2022 to present Prenatal diagnosis genetic counseling fee schedule, July 2021 to June 30, 2022 Prenatal diagnosis genetic 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Respiratory care billing guide, July 1, 2022 to July 31, 2022 Respiratory care billing guide, October 1, 2021 to June 30, 2022 Respiratory care billing guide, July 1, 2022 to present Respiratory care fee schedule, October 1, 2021 to June 30, 2022 Respiratory care fee schedule, July 1, 2021 to September 30, 2021 Respiratory care fee schedule, April 1, 2023 to present Rural heath clinics billing guide, January 1, 2023 to March 31, 2023 Rural health clinics billing guide, October 1, 2022 to December 31, 2022 Rural health clinics billing guide, April 1, 2023 to present RHC encounter rates, January 1, 2023 to March 31, 2023 RHC encounter rates, October 1, 2022 to December 31, 2022 RHC encounter rates, April 1, 2023 to present RHC enhancement rates, January 1, 2023 to March 31, 2023 RHC enhancement rates, October 1, 2022 to December 31, 2022 RHC enhancement rates, October1, 2022 to present SBHS billing guide, July 1, 2022 to September 30, 2022 SBHS billing guide, October 1, 2021 to June 30, 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