Billing Information: SEALANTS

Yes, the ABCD program allows reimbursement for sealants on
primary and permanent teeth.

D1351 Topical application of sealants - $22.22 per tooth
Tooth and surface designations required. Includes glass ionomer sealants.

• Sealants may be applied to occlusal surfaces of primary and permanent maxillary and mandibular first and second molars and lingual pits of teeth 7 and 10.

• Only teeth with no proximal decay will be covered.

• Sealants are restricted to children 0 through 18 years of age.

• The application of pit and fissure sealants will be covered only once per tooth in a 3-year period.

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