Dental Billing Services
MedPrecision provides dental billing services for general, pediatric and oral surgery practices that bill dental and medical insurance. Dental plans generally take the ADA Dental Claim Form or the 837D, while medical plans generally take the CMS-1500 or the 837P. We take over both sides, from benefit checks before the visit to follow-up on unpaid claims.
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What MedPrecision takes over for dental practices
MedPrecision's dental billing services cover eligibility, CDT coding, ADA-form claims, CMS-1500 medical cross-coding, payment posting, denials and A/R follow-up. Published rates are 7.0% of monthly collections for a solo practice and 6.0% for a group of 2 to 15 providers; the full terms are on our pricing page.
- CDT coding and ADA-form claims to dental PPOs and Medicaid dental
- Medical procedures cross-coded to medical plans on the CMS-1500
- Dentist enrollment with dental PPOs and Medicaid dental programs
- Patient balance statements and patient-side collections
Who This Page Is For
Common Billing Friction in Dental
The CDT code set changes every January 1
The CDT Code, maintained by the American Dental Association, is the HIPAA standard code set for dental services (45 CFR 162.1002). CDT 2027 takes effect on January 1, 2027, and the ADA counts 67 changes in it: 28 additions, 33 revisions, 0 deletions and 6 editorials. Each new version has to be loaded before January claims go out.
Dental and medical claims use different formats
The ADA Dental Claim Form, now in its 2024 version, provides a common format for reporting dental services to a dental benefit plan (ADA). For electronic claims, HIPAA names the X12 837 Dental (005010X224) and the 837 Professional (005010X222) as separate standards (45 CFR 162.1102), so each procedure has to go out in the format its payer expects.
One patient can carry dental and medical coverage
Items 4 to 11 of the ADA form, Other Coverage, report any additional dental or medical policy so the payer can determine coordination of benefits (ADA 2024 completion instructions). Item 4 is marked Dental? or Medical? whenever the patient has other coverage, whether the dentist or the patient files that claim. Items 5 to 11 then describe that other plan, and when both boxes are marked they describe the dental plan.
Medicare now requires a diagnosis code on dental claims
Item 34 of the ADA form carries ICD-10-CM diagnosis codes. The ADA requires Items 34 and 34a when the diagnosis may affect adjudication because specific dental procedures may minimize risks linked to the patient's oral and systemic health conditions, or when state regulation (such as Medicaid) or a payer contract requires them (ADA 2024 completion instructions). Since July 1, 2025, Medicare has required an ICD-10 code on dental-form claims, the 837D or the 2024 ADA form (CMS).
Sleep-apnea oral appliances follow Medicare DME rules
HCPCS code E0486 covers only custom fabricated mandibular advancement devices (Medicare article A52512). Under LCD L33611, Medicare denies the appliance as not reasonable and necessary unless criteria A to D are all met. The Medicare-covered sleep test must meet one of three AHI or RDI thresholds; one of them is at least 15 events per hour with a minimum of 30 events. The treating practitioner orders the device after reviewing the sleep test report, and a licensed dentist provides and bills it. The appliance claim is processed by the DME MACs that administer LCD L33611.
PPO networks such as Delta Dental re-credential dentists
Dental PPO networks such as Delta Dental credential dentists and then re-credential them on a later cycle. Delta Dental lets its contracted dentists do both online through DataSpring, powered by CAQH, at no cost (Delta Dental). Each dentist's dates have to be tracked network by network.
Dental-Specific Payer Issues We Watch For
Original Medicare
Issue: Medicare excludes dental services for the care, treatment, filling, removal or replacement of teeth or the structures directly supporting them (42 CFR 411.15(i)). Dental services inextricably linked to a covered medical service, such as the dental exam before an organ transplant, are not excluded, and payment may be made under Parts A and B. Since July 1, 2025, those claims need the KX modifier, and medical-dental coordination must be documented in the medical record (CMS).
Our approach: We check eligibility and benefits before the visit, so you know whether a Medicare patient also has a dental plan, Medicaid dental coverage or another medical plan.
Medicaid dental programs
Issue: When screening shows the need, Medicaid must provide EPSDT beneficiaries under 21 dental care for relief of pain and infections, restoration of teeth and maintenance of dental health, even when the service is not in the state plan (42 CFR 441.56(c), 440.40(b)). For adults 21 and older, dental is not a required service, so each State chooses whether to furnish it (42 CFR 440.210, 440.225).
Our approach: We check each patient's Medicaid dental benefits before the visit, file CDT claims on the ADA form, and enroll your dentists with the Medicaid dental programs you serve.
Dental PPO networks
Issue: A patient covered by a second dental plan must be reported in the ADA form's Other Coverage items so the plans can coordinate benefits. Networks such as Delta Dental also re-credential dentists on a later cycle.
Our approach: We run a benefit breakdown before treatment, file the ADA-form claims, and enroll your dentists with the dental PPO networks you join.
Medical plans for dental-practice procedures
Issue: Oral surgery, biopsies, trauma care, TMJ treatment and sleep-apnea oral appliances can be billed to the patient's medical plan on the CMS-1500 or the 837P. The dental claim still reports that medical plan in its Other Coverage items.
Our approach: We cross-code these procedures and bill them to the medical plan on the CMS-1500, while the dental side of the visit goes on the ADA form.
What We Handle
Eligibility and benefit breakdowns
We check dental and medical coverage before the visit and break down the benefits for the planned treatment.
CDT coding and ADA-form claims
We code procedures in CDT and file ADA-form claims to dental PPOs and Medicaid dental programs.
Medical cross-coding
Oral surgery, biopsies, trauma, TMJ and sleep-apnea appliances are cross-coded and billed to medical insurance on the CMS-1500.
Dental credentialing
We enroll your dentists with dental PPO networks and Medicaid dental programs.
Posting, denials and A/R follow-up
We post insurance payments, work denials and follow up on unpaid dental and medical claims.
Patient statements and collections
We send patient balance statements and handle patient-side collections.
Free Billing Audit · No obligation
Is your dental billing leaving money on the table?
We audit your last 90 days of dental claims for under-coding, modifier errors, and denials — and show you the recoverable dollars at no cost. Written findings in 3–5 business days.
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A billing specialist will review your practice details and reach out within 1 business day. No confirmation email is sent — if you need to reach us sooner, call +1-872-297-2815.
Why General Billing Teams Miss Dental Issues
General billing staff handle dozens of specialties and rarely develop the depth needed for dental coding nuances. Here is what gets missed.
Other Coverage on the dental claim
A team used to medical claims may skip the ADA form's Other Coverage items, which payers use to coordinate dental and medical benefits.
CDT, not CPT, on dental procedures
Dental procedures are coded in CDT, the HIPAA standard code set for dental services, not in CPT.
Who evaluates a sleep-apnea patient
Medicare's oral appliance policy requires an in-person evaluation before the sleep test by the treating practitioner, a term that excludes the dentist.
Transition Plan
Switching billing partners should not disrupt patient care or cash flow. Our transition plan is designed for zero downtime.
Discovery and Specialty Audit
We review your current dental billing workflows, denial patterns, and payer mix to build a tailored onboarding plan.
System Integration
We connect to your EHR and practice management system, configure specialty-specific code sets, and validate charge capture workflows.
Parallel Billing Period
We run billing in parallel with your current process for 2-4 weeks to verify accuracy before taking over completely.
Full Transition and Reporting
Once validated, we assume full billing responsibility with monthly reporting dashboards and a dedicated account manager.
Last updated: 2026-10-23
Common Questions
Common questions about dental billing services.
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Request ReviewHow much does MedPrecision charge for dental billing?
Our published rates are 7.0% of monthly collections for a solo practice and 6.0% for a group of 2 to 15 providers; larger groups are quoted individually. The full terms, and what each tier includes, are on our pricing page.
Can a dental practice bill medical insurance?
Yes, for medical procedures such as oral surgery, biopsies, trauma care, TMJ treatment and sleep-apnea oral appliances, billed to the medical plan on the CMS-1500 or the 837P. Our guide to the CO-22 coordination-of-benefits denial explains the denial a payer sends when another plan should pay first.
Do you credential dentists with dental PPO networks?
Yes, with dental PPO networks and Medicaid dental programs. Delta Dental, for example, lets its contracted dentists credential and re-credential online through DataSpring, powered by CAQH, at no cost. Our provider credentialing services page explains the enrollment process.
Does Medicare pay for dental work?
In limited cases. Original Medicare (Parts A and B) excludes dental care of the teeth and their supporting structures (42 CFR 411.15), but services inextricably linked to a covered medical service are not excluded, such as the dental exam before dialysis for end-stage renal disease. Those claims need the KX modifier, and dental-form claims an ICD-10 code (CMS).
Does Medicaid cover adult dental care?
It depends on the state: for adults 21 and older, dental is an optional service each State chooses whether to cover (42 CFR 440.225). Children under 21 are owed EPSDT dental care when screening shows the need, as our guide to EPSDT Medicaid billing for children explains.
What changes when we move dental billing from in-house staff to a dental billing company?
Eligibility checks, CDT coding, ADA-form claims, medical cross-coding, payment posting, denials and A/R follow-up move to us. Patient statements and collections can move too, as our patient billing and collections page describes. Your dentists keep writing the clinical notes that claims are coded from.
Related Services
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Tell us whether you run a solo or group practice, your monthly collections, the payers you bill and any medical procedures you perform, and we will reply with the rate that applies.
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