Dental Frequency Limitation Guide: 2022
How to use this guide:
- 'Ctrl+F' is the best way to search for specific CDT codes
- Anything that does not contain a frequency limitation, or only says "covered benefit" in the 'Procedure Guidelines or Frequency Limitation' column, does not have a defined limitation
- Anything listed as 'Not a covered benefit' means that none of our Planstin dental plans cover that service (these are shaded in gray to better identify)
- Cross reference this with the plan outline and tier guide/tier schedule/copay schedule to determine coverage - not all plans cover all services listed