Summary
Teledentistry keeps your practice connected with patients when office schedules get tight. This guide gives dental practice owners and office managers a practical way to plan virtual visits, from compliance and billing to technology, training, and rollout.
Key Points
- Three ADA modalities shape workflows
- HIPAA compliance requires vendor agreements
- Medicaid reimbursement is still limited
- Pilot first, then scale carefully
- Virtual visits support access and flow
Patients want faster, more convenient access to care, and teledentistry delivers it. 53% of dentists00342-2/fulltext) who adopted teledentistry cited increased patient convenience as their primary reason.
Demand may be growing, but adoption barriers are still real. Inconsistent reimbursement, limited digital infrastructure, and a lack of standardized protocols can all slow practices down. The good news is that the regulatory framework, billing codes, and technology tools are already in place for practices ready to move forward.
This article breaks down what you need to know and what to do to bring virtual visits into your dental practice.
Understanding the Three Types of Teledentistry
The ADA defines teledentistry as “the use of telehealth systems and methodologies in dentistry.” Rather than a single service, teledentistry is a collection of delivery methods. Each modality has its own workflow, billing code, and clinical use case.
1. Synchronous, Live Video
A real-time, two-way video interaction between a patient and provider. Think of it as a face-to-face appointment conducted over a screen. Practices bill synchronous visits using CDT code D9995.
Common uses include emergency triage consultations, post-operative check-ins, and initial screenings for new patients.
2. Asynchronous, Store-and-Forward
In this model, a team member captures images, radiographs, or video and transmits them securely. The dentist reviews them later on their own schedule, with no real-time interaction required. Practices bill asynchronous encounters using CDT code D9996.
This approach works well for hygiene-driven exams because the dentist reviews hygienist-captured images and assessments independently, separating care delivery from provider availability.
3. Remote Patient Monitoring
RPM involves collecting personal health and medical data from a patient in one location and transmitting it electronically to a provider in another. Orthodontic monitoring devices and apps are the most common examples, and RPM can function in either a synchronous or asynchronous manner. No standalone CDT code exists for RPM, so practices typically bill it alongside D9995 or D9996 depending on delivery method.
Both D9995 and D9996 are add-on codes that must be reported alongside other procedure codes, not as standalone charges.
Getting the Compliance Essentials Right
Three areas of regulatory compliance need attention before you schedule your first virtual visit. Address HIPAA, state licensing, and informed consent before anything else.
HIPAA and Platform Security
The temporary HIPAA enforcement relaxation from the COVID-19 pandemic has ended. Every digital platform your practice uses must meet HIPAA privacy requirements.
The compliance obligation falls on the provider, not the patient. Your video platform must support encrypted communication, and any vendor that stores or transmits electronic protected health information must sign a written Business Associate Agreement. That requirement applies to video platforms, cloud storage, and any SaaS teledentistry software.
Train staff on HIPAA compliance and patient data security as part of your launch preparation.
State Licensing Requirements
Teledentistry regulation varies by state, and licensing requirements follow the patient, not the provider. Dentists must be licensed in the state where the patient is located when the service is delivered.
State rules differ widely across all 50 states and D.C. Some states have detailed requirements, while others remain vague and open to interpretation. Verify your state’s rules directly with your dental board before launching.
Informed Consent
You must obtain and document patient consent before delivering any teledentistry services. Your consent form should cover the following.
- Acknowledgment that the dentist will not be physically present
- Understanding that a full diagnosis may not be available
- Specific consent to transmitting patient information over electronic networks
Requirements vary by state, so check your state dental board for specifics.
Technology You Need to Launch
You do not need to overhaul your entire tech stack. Simple implementations, such as advice and referral consultations, have minimal hardware and software requirements. Here is what to prioritize.
HIPAA-Compliant Video Platform
Your platform must include security features to prevent data interception during transmission. Look for integration with your existing practice management system and clear audio and video quality for oral health assessments. Confirm BAA availability directly with any vendor before committing.
Intraoral Camera
Essential for asynchronous encounters. Handheld intraoral cameras capture the clinical detail teledentistry exams require. Look for high-resolution capture and easy maneuverability within the patient’s mouth.
Integrated Practice Management System
Building teledentistry delivery systems from disconnected software creates unnecessary friction. Prioritize platforms that store electronic dental records, support video sessions, offer a patient portal with image upload capabilities, and enable text messaging within the platform.
Secure Network Infrastructure
Ensure adequate bandwidth for high-resolution dental images. Implement role-based access controls, secure email or VPN connections, and regular security audits. Any cloud storage provider must sign a BAA.
A Step-by-Step Plan for Implementation
The ADA, AGD, and CareQuest Institute all independently endorse the same approach. Start small, pilot first, then scale. Here is how to structure your rollout.
Step 1. Define Your Use Case
Pick one or two scenarios to start with. The ADA identifies four categories ranging from simple to complex. Pre- and post-visit interactions with existing patients require the least new infrastructure, minimal new procedures, software, or equipment.
Step 2. Complete Regulatory Due Diligence
Before launch, confirm what teledentistry services your state permits, verify HIPAA and 21st Century Cures Act compliance for all equipment and software, understand billing rules with your specific payers, and identify who serves as the provider of record in your workflow.
Step 3. Train Your Team
Staff training should cover three core areas. Start with what teledentistry is and how your practice will use it. Then move to hands-on operation of the specific technology. Finish with cybersecurity and patient data protection protocols.
Create dedicated time for staff to test the full workflow in a practice environment before going live. Plan for a learning curve at the front desk, because scheduling virtual consultations alongside in-office appointments takes practice.
Step 4. Run a Pilot
Dedicate a few hours per day or a single use case to testing. Pilot-appropriate scenarios include limited evaluation and triage, hygiene assessments, and patient consultations. Establish internal baselines during this phase and measure trends against them.
A simple pilot checklist keeps the process manageable.
- Confirm your first use case
- Verify platform and BAA setup
- Train staff on workflow steps
- Test scheduling and documentation
- Review coding and payer rules
Running through each item before going live makes it easier to spot gaps before a full rollout.
Step 5. Prepare Your Patients
Before the visit, send instructions confirming patients have the necessary technology. During the visit, begin with a brief non-dental check-in to ease anxiety. After the visit, send summary messages reinforcing advice and next steps.
How Virtual Visits Benefit Your Patients and Your Practice
Virtual visits shorten appointment times, free up chair time, and reduce patient wait times. Those benefits compound as practices scale.
For patients, the triage capability alone is valuable. Virtual assessments determine whether issues require immediate in-person care or can be managed remotely. That keeps your schedule focused on the patients who need to be in the chair.
Virtual visits can also serve as a low-pressure re-entry point. Lapsed patients who have avoided the office for years often respond positively to a virtual appointment as a first step back.
Navigating Insurance Reimbursement
Reimbursement remains the most fragmented part of the teledentistry puzzle, so plan your revenue model carefully.
Medicaid coverage for D9995 and D9996 varies dramatically by state. Many state Medicaid programs either do not recognize these codes or list them at $0.00 under fee-for-service. On the private insurance side, some states have parity laws requiring insurers to reimburse telehealth services at the same rate as in-person care, but parity laws do not exist in every state. Medicare excludes routine dental care, including teledentistry.
The practical takeaway is simple. Plan for revenue to come primarily from the underlying procedure codes billed alongside D9995 or D9996, not from the teledentistry add-on codes themselves.
Taking the Next Step With Confidence
Teledentistry works best when you treat it like any other care delivery model. Start with a narrow use case, confirm your compliance requirements, and build a workflow your team can repeat consistently. That approach reduces friction for staff and makes the patient experience more predictable.
The long-term opportunity goes beyond convenience. Virtual visits improve access, support triage, and keep care moving when in-person scheduling is tight.
As you evaluate your next step, keep your focus on patient communication and operational clarity. Book a quick demo to see how financing conversations can improve your patient communications.Become a Sunbit Partner.
