Policy Number: DP-X-004

Last Updated: Sept. 15, 2022

The initial banding charge should be up to one-third of the total charge. After the initial banding, the provider may bill monthly or quarterly (three-month increments) for the remainder of treatment, until the benefit is exhausted. Billing may be submitted monthly on the first of the month, regardless of whether the patient was seen on that date, or quarterly, with the three months listed under the line charge or in the comments field.   

Reimbursement for other orthodontic treatments will be the same as regular orthodontics. Invisalign is a mode of treating orthodontics; therefore, this policy applies to Invisalign orthodontics also.