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Stay Ahead of GEHA Dental Insurance Updates: What You Need to Know for 2025
As we step into 2025, dental providers need to be aware of key changes and updates from GEHA Connection Dental Network that could impact billing, claims, and compliance. Staying informed ensures you avoid claim denials, maintain compliance, and optimize reimbursements. Let’s break down the most important updates in a simple and easy-to-follow format.
CDT Code Updates for 2025
Effective January 1, 2025, GEHA has implemented changes to its CDT fee schedules. This means providers must use the new CDT codes for all treatments from this date onward. Here’s what’s changing:
- New CDT Codes Added: D6089, D6180, D6193, D7252
- CDT Code Deleted: D6095 (Make sure to remove this from your billing system to avoid claim rejections.)
To stay compliant, providers should refer to the 2025 ADA CDT Manual for full details on these procedure codes. If you haven’t already reviewed these changes, now is the time!
New ADA Dental Claim Form Requirement
UnitedHealthcare (UHC) has mandated the use of the updated 2024 ADA dental claim form for all submissions. This means that if you’re still using an older version, your claims may be rejected. To access the latest form and instructions, visit connectiondental.com/networkinfo/getdocumentfile/191.
Illinois Providers: New Network Transparency Law
If you’re a provider in Illinois, House Bill 5395 introduces new regulations requiring:
- Provider directory verification every 90 days
- Notification of directory updates within 10 business days
To comply, providers can submit updates via:
- Phone: 800.505.8880 (Option 4)
- Email: CDNstateverification@geha.com
- Fax: 816.257.3238
Failure to update your information could lead to issues with reimbursement or patients having incorrect network information. Mark your calendars for regular verification!
Other Important GEHA Updates for 2025
- Fee Schedules: The updated 2025 fee schedules are available via IVR, the provider portal, or by phone (800.505.8880, Option 3).
- FEDVIP Benefits Expansion: The Federal Employees Dental and Vision Insurance Program (FEDVIP) now covers D2991 & D6089 under its benefits.
- Standard Option Plan Change: If you have out-of-network patients, be aware that there is now a $75 deductible for Class A, B, and C services.
- Medicare Advantage Enrollment Growth: More Medicare Advantage plans are now offering dental benefits, so it’s crucial to verify your participation in these networks to expand your patient base.
Take Action Now
- Review and implement CDT code changes in your billing systems.
- Start using the new ADA claim form for all UHC claim submissions.
- Verify and update your provider directory information if you’re in Illinois.
- Check the updated fee schedules to ensure accurate billing and reimbursements.
- Confirm your Medicare Advantage participation status to attract new patients.
Keeping up with these changes now will save you time, reduce denials, and improve your practice’s efficiency. Need more details? Contact GEHA directly or log into your provider portal today.
If you have questions about how these updates impact your practice’s billing and reimbursements, feel free to reach out to us. We’re here to help simplify dental billing so you can focus on providing excellent patient care!
