MSP Billing Codes

Specialty: Orthodontic Specialists

Code	Description	Fee
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03964	Newborn-initial examination & expl. re: nature of	$95.05
03965	Ortho care of newborn < 2yrs. bone-moving	$1,325.02
39966	Orthodontic care of newborn - unilateral	$3,809.01
39967	Orthodontic care of newborn - bilateral	$4,847.85
39968	Orthodontic care of newborn - bilateral	$1,500.00
03955	Deciduous - simple - malocclusion req. the use of	$2,902.34
03956	Deciduous - complex-malocclusion req. 2 or more	$2,902.34
03957	Severe - malocclusion req. 2 or more removable	$2,902.34
03978	Full alignment & retention.- initial exam.	$95.05
03979	Full alignment and retention - diagnostic phase -	$304.18
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03980	Full alignment and retention - case analysis and	$221.78
03970	Initial exam.-will include clinical exam.and exp.	$95.05
03971	Diagnostic phase-diagnostic models,facials,	$304.18
03972	Case analysis & conslt.includes treatment planning	$221.78
03958	Mixed dentition - simple - malocclusion req.use of	$2,902.34
03959	Mixed dentition - complex- malocclusion req. 2 or	$2,902.34
03960	Mixed dentition - severe-malocclusion req. 2 or	$2,902.34
03966	Observation & adjustments -(observation to be	$38.03
03967	Observation & adjustments - serial extraction	$57.34
03968	Observation & adjustments - removable appliance	$43.10
03969	Observation & adjustments - fixed appliance - to	$39.98
03952	Severe congenital cranio-facial anomalies-initial	$95.05
03953	Severe congenital cranio-facial /diagnostic phase	$304.18
03954	Severe congenital cranial-facial anomalies - case	$221.78
03961	Permanent dentition - simple - malocclusion req a	$2,902.34
03962	Permanent dentition - complex-malocclusion	$2,902.34
03963	Permanent dentition-severe-malocclusion req. a	$2,902.34
39976	Palatal fistula obturator	$1,152.68
39977	Continuing care of palatal fistula obturator	$48.75
39978	Remake of a palatal fistula obturator	$764.42
39979	Speech obturator	$7,598.06
39980	Simple continuing care of speech obturator	$97.47
39981	Complex continuing care of speech obturator	$487.44
39982	Speech obturator remake	$5,063.27
39983	Speech lift	$5,760.33
39984	Continuing care of speech lift	$73.12
39985	Speech lift remake	$3,840.22
03973	Simple - malocclusions req. uncomplicated	$2,758.48
03974	Complex - malocclusions req. one complexed fixed	$1,032.93
03975	Severe - malocclusions that req. one or more	$1,267.41
03981	Class 1 malocclusions-simple - requiring banding	$1,774.37
03982	Class 1 malocclusions-complex-full banding of both	$1,869.42
03983	Class 1 malocclusions - severe- requiring full	$1,964.46
03984	Class 11 malocclusions-simple requiring banding in	$1,964.46
03985	Class 11 malocclusions - complex-requiring full	$2,059.52
03986	Class 11 malocclusions-severe - full banding of	$2,154.56
03987	Class 111 malocclusions - simple - banding in both	$1,964.46
03988	Class 111 malocclusions - complex - full banding	$2,059.52
03989	Class 111 malocclusions - severe - requiring full	$2,154.56

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