MSP Billing Codes

Specialty: Orthodontic Specialists

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Code Description Fee

Cleft Lip and / or Palate - Care of Newborn

03964 Newborn-initial examination & expl. re: nature of $95.05
03965 Ortho care of newborn < 2yrs. bone-moving $1,325.02
39967 Orthodontic care of newborn - bilateral $4,847.85
39968 Orthodontic care of newborn - bilateral $1,500.00
39966 Orthodontic care of newborn - unilateral $3,809.01

Deciduous

03956 Deciduous - complex-malocclusion req. 2 or more $2,902.34
03955 Deciduous - simple - malocclusion req. the use of $2,902.34
03957 Severe - malocclusion req. 2 or more removable $2,902.34

Full Alignment and Retention

03978 Full alignment & retention.- initial exam. $95.05
03980 Full alignment and retention - case analysis and $221.78

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03979 Full alignment and retention - diagnostic phase - $304.18

Initial Expansion and Corrective Dental Alignment

03972 Case analysis & conslt.includes treatment planning $221.78
03971 Diagnostic phase-diagnostic models,facials, $304.18
03970 Initial exam.-will include clinical exam.and exp. $95.05

Mixed Dentition

03959 Mixed dentition - complex- malocclusion req. 2 or $2,902.34
03960 Mixed dentition - severe-malocclusion req. 2 or $2,902.34
03958 Mixed dentition - simple - malocclusion req.use of $2,902.34

Observation and Adjustments

03969 Observation & adjustments - fixed appliance - to $39.98
03968 Observation & adjustments - removable appliance $43.10
03967 Observation & adjustments - serial extraction $57.34
03966 Observation & adjustments -(observation to be $38.03

Orthodontic Services for Severe Congenital Cranial-Facial Anomalies

03954 Severe congenital cranial-facial anomalies - case $221.78
03953 Severe congenital cranio-facial /diagnostic phase $304.18
03952 Severe congenital cranio-facial anomalies-initial $95.05

Permanent Dentition

03962 Permanent dentition - complex-malocclusion $2,902.34
03961 Permanent dentition - simple - malocclusion req a $2,902.34
03963 Permanent dentition-severe-malocclusion req. a $2,902.34

Speech Obturator

39981 Complex continuing care of speech obturator $487.44
39977 Continuing care of palatal fistula obturator $48.75
39984 Continuing care of speech lift $73.12
39976 Palatal fistula obturator $1,152.68
39978 Remake of a palatal fistula obturator $764.42
39980 Simple continuing care of speech obturator $97.47
39983 Speech lift $5,760.33
39985 Speech lift remake $3,840.22
39979 Speech obturator $7,598.06
39982 Speech obturator remake $5,063.27

Treatment Phase

03983 Class 1 malocclusions - severe- requiring full $1,964.46
03982 Class 1 malocclusions-complex-full banding of both $1,869.42
03981 Class 1 malocclusions-simple - requiring banding $1,774.37
03985 Class 11 malocclusions - complex-requiring full $2,059.52
03986 Class 11 malocclusions-severe - full banding of $2,154.56
03984 Class 11 malocclusions-simple requiring banding in $1,964.46
03988 Class 111 malocclusions - complex - full banding $2,059.52
03989 Class 111 malocclusions - severe - requiring full $2,154.56
03987 Class 111 malocclusions - simple - banding in both $1,964.46
03974 Complex - malocclusions req. one complexed fixed $1,032.93
03975 Severe - malocclusions that req. one or more $1,267.41
03973 Simple - malocclusions req. uncomplicated $2,758.48

The information presented on this page is general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.

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