Orthodontic Billing Services

Orthodontic billing works differently from most dental billing. Treatment runs for many months, so a single case creates a long stream of payments, claims, and balances. Dental plans often pay a lifetime orthodontic maximum, sometimes in an initial payment and then in monthly installments, and the rules vary by plan.

Orthodontic billing uses CDT codes, not CPT. Patients often have a separate dental plan, and a few cases, such as jaw surgery or craniofacial care, may touch medical coverage. Westmont Revenue Partners connects orthodontic practices with vetted billing experts who know how to manage contracts, track benefits, and keep claims moving over the length of treatment.

Who this is for

• Orthodontists in solo, group, and multi-office practices
• Practices treating children, teens, and adults
• Offices that offer in-house payment plans
• Practices working with clear aligner or traditional braces cases
• Teams that want help with long-running accounts receivable

What gets billed

• New patient exams and records
• Comprehensive orthodontic treatment for adolescents
• Comprehensive orthodontic treatment for adults
• Periodic adjustment visits
• Retention and appliance removal
• Removable appliance therapy
• Exposure of impacted teeth with an oral surgeon
• Diagnostic x-rays
• Replacement of lost or broken appliances
• Patient contract and installment billing

Commonly billed codes

Code	Type	What it covers
D0150	CDT	Full exam for a new or returning patient
D0210	CDT	Full set of intraoral x-rays
D0220	CDT	First single periapical x-ray
D8080	CDT	Full braces treatment for an adolescent
D8090	CDT	Full braces treatment for an adult
D8670	CDT	Routine adjustment visit during treatment
D8680	CDT	Retention phase and appliance removal
D8210	CDT	Removable appliance therapy
D7280	CDT	Exposure of an unerupted tooth, often for orthodontics
D7283	CDT	Device placed to help an impacted tooth erupt

Note

Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.

Billing challenges in orthodontics

• Lifetime maximums. Many plans pay a set lifetime amount per patient. A biller tracks what has been used and what remains so the patient plan is built on real numbers.
• Waiting periods. Some plans require months of coverage before orthodontic benefits start. A biller verifies this before the contract is signed.
• Installment claims. Some plans pay in an initial amount and then pay over time. A biller sets reminders so later claims are filed on schedule.
• Plan changes mid-treatment. When a patient switches jobs or plans, the new plan may cover only part of the case. A biller checks what carries over and updates the contract.
• Age limits. Many plans stop orthodontic coverage at a set age. Early checks prevent surprises for older teens and adults.
• Two plans. Dual coverage raises order-of-benefits questions, and each plan may handle orthodontics differently. A biller sequences claims carefully.
• Contract and collections tracking. Long payment plans need clear statements and follow-up. A biller keeps patient accounts current without straining the relationship.

How Westmont can help

• Matching you with vetted billing experts experienced in orthodontic billing
• End-to-end revenue cycle support, from benefit checks to patient statements
• Denial management and claim follow-up on long-running cases
• Support with payer enrollment and credentialing
• Help tracking lifetime maximums and installment claims

Frequently asked questions

How do orthodontic insurance benefits work?

Many dental plans pay a one-time lifetime orthodontic maximum instead of an annual one. Some pay part up front and the rest over the treatment period. Plans differ on age limits, waiting periods, and covered appliances. A biller checks the patient's benefits before treatment starts and reviews the details with the family.

What CDT codes do orthodontists use?

Orthodontists bill CDT codes such as D8080 for adolescent comprehensive treatment, D8090 for adult comprehensive treatment, D8670 for periodic visits, and D8680 for retention. Exams and x-rays also use CDT. Code sets are updated each year, so confirm current codes and payer rules before billing.

Can orthodontic work be billed to medical insurance?

Rarely, and only in certain cases such as craniofacial conditions or care tied to jaw surgery. Medical plans set their own rules and often require prior authorization and medical codes. Most orthodontic billing goes to dental plans. Check with the specific payer before submitting anything to medical coverage.

What happens if a patient changes dental plans during treatment?

The new plan may apply a waiting period, a different maximum, or may exclude cases already in progress. A biller reviews the new plan, tells the patient what is likely to be covered, and updates the payment contract. Always confirm details with the new plan directly.

Is it worth outsourcing orthodontic billing?

Orthodontic accounts last a long time, which makes them easy to lose track of. A billing partner can monitor benefits, file claims on schedule, and follow up on balances. Consider the cost, reporting, and software fit before deciding.

Related billing services

• General Dentistry
• Pediatric Dentistry
• Dental Oral Surgery
• Prosthodontics
• Oral and Maxillofacial Surgery