Reimbursement for dental therapy services
Billing and NPI issues
Services provided by a dental therapist can be billed under the dentist's name for commercial insurance and some MA. The Minnesota Department of Human Services (DHS) offers guidance on reimbursement for dental therapists for services provided to Minnesota Health Care Program Patients. Note that a dental therapist must obtain a National Provider Identifier (NPI), and if she or he is also working as a licensed collaborative practice hygienist, a separate NPI must be obtained for work done under that license. These numbers allow the DHS to track how many and what type of procedures are being done by each type of provider. Only straight MA and Dentaquest require a dental therapist to bill under their own separate NPI.
Note also that in the most current DHS dental therapist notice posted November 2013, as part of the guidance linked in the above paragraph, reimbursement for services provided by dental therapists will be made at the rate of 100% for dental therapy services.
As dentists begin preparing for retirement, it can be very helpful to bring a dental therapist on board. This allows the practice to operate productively with the dentist doing the "high end" procedures and the therapist operating at full capacity so that when it comes time to sell the practice, it's operating at capacity and may be worth more. With the therapists having learned contemporary dentistry, a younger dentist seeking to purchase a practice may well find such a practice appealing.