Periodontal Maintenance (2023 Policy) PDF. Opens in a new window
Defines clinical indications, documentation and coding guidance for periodontal maintenance as a therapeutic, nonsurgical continuing care procedure following definitive periodontal treatment; provides CDT codes for informational use and references. It is guidance for applying dental benefit medical necessity and appropriateness determinations.
No material clinical/coverage changes.
Coverage Summary
Scope: Defines clinical indications, documentation and coding guidance for periodontal maintenance as a therapeutic, nonsurgical continuing care procedure following definitive periodontal treatment; provides CDT codes for informational use and references. It is guidance for applying dental benefit medical necessity and appropriateness determinations.
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