Dental Professionals
Enhanced Reimbursement System

Aged 0-2 Years Aged 3-5 Years
D0145 Oral Evaluation of a Patient Under 3 Years of Age and Counseling with Primary Caregiver D1310 Nutritional Counseling for Control of Dental Disease
D0425 Caries Susceptibility Tests (“Caries Risk Assessment”)* D1330 Oral Hygiene Instructions
D1310 Nutritional Counseling for Control of Dental Disease
D1330 Oral Hygiene Instructions
D0601, D0602, or D0603 Caries Risk Assessment Findings: Low, Medium, High*

*For children aged 0-2 years, AbCd MT Caries Risk Assessment (D0425) must be completed at least once every 12 months and the results of the assessment retained in the dental record. When submitting a dental claim for AbCd MT Caries Risk Assessment (D0425) also submit the outcome of the assessment as the appropriate and corresponding Caries Risk Assessment Finding code (D0601, D0602, or D0603).

For children aged 0-2 years with an AbCd MT Caries Risk Assessment finding of “High” (D0603) might consider providing up to 6 AbCd MT recall visits per year. The frequency of the recall visits should be supported in the dental record by noting the condition being treated or prevented and the associated level of ongoing risk. For children aged 0-2 years, all of the associated CDT codes noted in the AbCd MT Risk-based Age Dependent Table of Benefits and fluoride varnish (D1206) may be provided at each subsequent visit as indicated by medical necessity. The dentist determines which services are appropriate and medically necessary and is responsible for appropriate documentation of each service. Services performed must be in compliance with the CDT code descriptions in effect at the time of service.

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