Provider FAQs About GEHA's Dental Benefits and COVID-19

GEHA has made updates to our dental plans to help our members during this time. We answer some of the frequently asked questions providers are asking about these changes below.

  • Is GEHA covering any additional services, due to the national emergency?

    We will cover the use of a protective restoration (D2940) to alleviate pain in certain circumstances, from March 1 through July 31, 2020, as recommended by the American Dental Association (ADA).
  • Are teledentistry services covered?

    Effective from March 1 through July 31, 2020 only, we will accept claims for an exam through a teledentistry consultation, only when required to determine a member’s need for emergency care. By allowing this additional consultation type during the COVID-19 timeframe, we are increasing the member maximum from two exams to three exams for 2020. This maximum can be met through any combination of allowed exam types, typically via routine cleaning/exam appointments.

    The claim should list the limited oral evaluation code (D0140) and the teledentistry code (D9995), however the teledentistry code is descriptive only and not billable to GEHA or the patient.
  • Is GEHA going to cover the cost for Personal Protective Equipment (PPE) that we bill to patients?

    GEHA recognizes the cost of Personal Protective Equipment (PPE) has increased during the COVID-19 pandemic. To assist our GEHA Connection Dental Plus and Connection Dental Federal participating providers, we are reimbursing $7 per patient visit when PPE code D1999 is billed, so long as it is accepted as payment in full, with no additional billing to the patient. This benefit will be in effect from July 1, 2020, through December 31, 2020.
  • What if my patient requires consult with a medical provider?

    While not currently a covered service, GEHA will allow a consultation with a medical health care professional from March 1, 2020 through July 31, 2020. Additionally, this will be a covered code beginning in 2021.
  • What if my patient is in the process of getting a dental implant?

    Implant services are limited to an annual maximum benefit of $2,500 per member, but, on the High Option only, we will rollover the unused maximum allowed benefit to 2021.
  • What if a dependent child’s coverage ended due to their age, while dental offices were closed?

    If a dependent child’s coverage ends due to the dependent age cutoff from March 1 through July 31, 2020, we will extend their coverage through December 31, 2020.