CommercialCoverageMedium impact
Dental Provider Notification – Frequency of Fillings (D2140-D2430)
EmblemHealth·Dentistry, Oral & Maxillofacial Surgery·Provider News
Effective date
Jan 1, 2027
We identified it
Jun 20, 2026
Summary
EmblemHealth is changing the frequency limit for dental fillings (D2140-D2430) from once every 6 months to once every 12 months on the same tooth by the same provider, effective January 1, 2027. This change also applies to inlays, onlays, veneers, crowns, or crown retainers performed after fillings on the same tooth within the last 12 months.
Action Required
Before January 1, 2027: Billing team must update dental billing software to enforce the new 12-month frequency limitation for fillings (D2140-D2430) on the same tooth by the same provider. Update system to also apply this frequency restriction to inlays, onlays, veneers, crowns, or crown retainers performed after a history of fillings on the same tooth within the last 12 months. Train staff on the new frequency requirements to prevent claim denials.