D9997 Dental case management special needs
Also known as: special needs management, special care coordination, special populations care
Dental case management services specifically for patients with special healthcare needs, including coordination, planning, and support addressing unique medical and psychosocial barriers.
In Plain Language
special care coordination for complex needs; comprehensive care planning
Clinical Context
Used for case management specific to patients with developmental disabilities, medical compromises, behavioral challenges, or psychosocial complexities requiring comprehensive coordination and specialized approaches.
RVU Information
CPT D9997 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
Dental codes (CDT codes) require documentation of the tooth number(s) or area treated, clinical findings, and the procedure performed. Pre-authorization may be required for major restorative, prosthodontic, and oral surgery procedures. Include radiographs when supporting medical necessity.
Specialties
Frequently Asked Questions
What is CPT code D9997?
CPT D9997 (Dental case management special needs) is a D Codes (Dental) code. Dental case management services specifically for patients with special healthcare needs, including coordination, planning, and support addressing unique medical and psychosocial barriers.
Is D9997 covered by dental insurance?
CPT D9997 is a dental procedure code used by Special Needs Dentistry, General Dentistry, Pediatric Dentistry. Used for case management specific to patients with developmental disabilities, medical compromises, behavioral challenges, or psychosocial complexities requiring comprehensive coordination and specialized approaches. Coverage depends on your dental insurance plan.
When is CPT D9997 used?
Used for case management specific to patients with developmental disabilities, medical compromises, behavioral challenges, or psychosocial complexities requiring comprehensive coordination and specialized approaches.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against MGMA data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.