General Notice on PPE

For Blue Cross and Blue Shield® Plans in Illinois, Montana, New Mexico, Oklahoma and Texas, claims with dates of service 7/1/2020 – 8/31/2020 will be paid up to $10 per member, per date of service to cover PPE expenses for in-network dentists.

In order to receive this payment, the following requirements must be met:

A dentist must be an in-network dental provider; and
A dentist must see patient and perform a service in their dental office; and
A dentist must submit code D1999 for their PPE expense; and
The date of service should fall between 7/1/2020 and 8/31/2020; and
Claim must be submitted by 10/2/2020.

How PPE payments will work:

Dentists wishing to be reimbursed for PPE must submit code D1999 along with the other services performed in office for patient when submitting claim.
- When the claim is processed, reimbursement for code D1999 will initially be denied with a remark code as follows:
  
  THIS PROCEDURE HAS BEEN DENIED. IT IS NOT COVERED UNDER THE MEMBER'S DENTAL PLAN. HOWEVER, IT WILL BE RE-EVALUATED FOR PERSONAL PROTECTIVE EQUIPMENT ALLOWANCE CONSIDERATION.
- Subsequently, once a week, all claims submitted with code D1999 will be reviewed and an additional payment will be made to in-network dentists.
- Do not balance bill member when the initial EOB is received because PPE payments will be made separately.
- PPE payments may not be applicable for certain benefit plans.

As a courtesy to our members and our in-network dental providers, we will be reviewing all claims already submitted for dates of service during the months of April, May and June for PPE payment. Claims previously submitted with code D1999 will be re-evaluated. Do not resubmit any claims that have already been submitted.

If a member previously made payments for PPE, the member may need to be refunded.

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