Are Fluoride Varnishes, like fluoride gel treatments, covered by dental insurance?

The only correct answer is that it depends on the patient’s policy. There is a new varnish code added by the CDT 2007-2008, code D1206 (fluoride varnish application), but it is only reimbursed for documented high-risk patients. This is defined as patients with a history of caries or hypersensitivity. There are no age restrictions with code D1206. For routine topical fluoride treatment, code D1208 (topical fluoride application) is now used for primary, permanent and mixed dentition. Patients under age 15 are routinely reimbursed under D1208. Adult patient reimbursement generally requires further documentation involving their risk assessment. For patient hypersensitivity related to root planning or surgical procedures, code D1206 should be used along with thorough high-risk documentation to ensure reimbursement. Allowable high-risk medical necessities include: Patient diagnosed with diabetes, high caries risk, SRP sensitivity, pregnancy and high-risk Diagnodent® readings. With the increased usage of fluoride varnish, most offices are already knowledgeable as to which patient insurance plans cover specific procedures and which codes apply.