- REMINDER: PCP names are not required on member ID cards for any line of business. Members should not be turned away if a PCP name is not listed. Please access CareFirst Direct to verify eligibility and benefits.
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.
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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