- CareFirst CHPMD Providers: Starting 11/2, you can submit medication prior authorizations electronically through the CareFirst Provider Portal. For more information watch this recorded webinar or access the step-by-step guide.
- All Providers: Billing NPI Reminder:The billing NPI submitted on claims must match the billing NPI on file with CareFirst,NPPES and MPRIME(CareFirst CHPMD). If your billing NPI is not enrolled with CareFirst, add it here .
Change Healthcare notifying individuals of data breach. Learn more here.
Dental Clinical Criteria
The Dental Clinical Criteria are based upon procedure codes in the Current Dental Terminology provided by the American Dental Association.
Click to view the individual section PDF or download and print the full Complete Dental Clinical Criteria document.
Download the complete
Dental Clinical Criteria
- Introduction - Part 1
- Diagnostic - Part 2
- Restorative - Part 3
- Endodontics - Part 4
- Periodontics - Part 5
- Prosthodontics (Removable) - Part 6
- Implants and Related Services - Part 7
- Fixed Prosthodontics - Part 8
- Oral Surgery - Part 9
- Orthodontic Treatment - Part 10
- Adjunctive General Services - Part 11