Providers
2025 Dental Xtra
The oral health of your patients can have a big impact on their overall health, especially if they’ve been diagnosed with certain medical conditions. For members with medical and dental plans with Arkansas Blue Cross, we’re able to review their medical claims to identify and automatically enroll those with qualifying health conditions (listed in the grid below) that benefit from additional dental care. We conduct outreach and education to make sure our members are aware of the positive impacts preventive and/or periodontal dental services have on their total well-being.
Your Partnership with Arkansas Blue Cross
Our Dental Xtra program allows us to combine expertise in all disciplines of comprehensive care. By partnering with Arkansas Blue Cross, you can help your patients who have medical conditions that might benefit the most from preventive dental care. Through Dental Xtra, you can:
- Help your patients achieve better overall health
- Easily identify patients eligible to enroll, or already enrolled, in the program, so they can take advantage of enhanced dental benefits
- Increase your revenue by providing additional services
Effective 1/1/2025
D4355 full mouth debridement to enable a comprehensive oral evaluation and diagnosis on a subsequent visit will be covered once every 24 months at 100% when enrolled in the program (applicable to all covered conditions).
D0120 Periodic oral evaluation (oral health screening) is covered four time per calendar year if member is enrolled in the program for oral, head and neck cancers or Sjögren syndrome.
| Two additional cleanings or periodontal maintenance visits, plus: | |||
|---|---|---|---|
| Eligible medical conditions | Scaling covered 100% | Enhanced cleaning to remove excess plaque buildup | Oral health screenings; fluoride treatments |
| Chronic Obstructive pulmonary disease* | ✔covered | ✔covered | not covered |
| Coronary artery disease | ✔covered | ✔covered | not covered |
| Diabetes | ✔covered | ✔covered | not covered |
| End-stage renal disease* | ✔covered | ✔covered | not covered |
| Metabolic syndrome* | ✔covered | ✔covered | not covered |
| Oral, head and neck cancers | not covered | ✔covered | ✔covered |
| Pregnancy | ✔covered | ✔covered | not covered |
| Sjögren's syndrome | not covered | ✔covered | ✔covered |
| Stroke | ✔covered | ✔covered | not covered |
| Note: Chronic obstructive pulmonary disease (COPD), End-stage renal disease (ESRD) and Metabolic syndrome (MetS) are not covered conditions for Medicare Advantage. | |||
Enhanced dental benefits at no additional cost
We’ve made it easier financially for your patients to take advantage of the program:
- Services do not count toward the annual maximum
- There are no deductibles, copayments or coinsurance (when seen by a participating provider), and waiting periods do not apply
- The benefits are worth more than $1,000 for each enrolled member – additional revenue for your practice
How do my patients enroll?
Members who have medical and dental plans through Arkansas Blue Cross and a qualifying medical condition are auto-enrolled in the program. Members who have only a dental policy with Arkansas Blue Cross or are pregnant must self-enroll. If your patient qualifies and needs to self-enroll, they can do so at arkansasbluecross.com/members/dental-xtra. Once you have identified members who are enrolled, we encourage setting up their four prophy recalls.
For more information about the impact oral health has on the qualifying conditions, please visit: arkansasbluecross.com/members/dental-xtra