2026 Dental Insurance and CDT Code Updates

A Dentistry Support® Guide for Dental Offices

The 2026 CDT update is now in effect for dates of service beginning January 1, 2026, and it includes 60 total code set changes across new codes, revisions, deletions, and editorial updates. ADA News+2ADA News+2

Because insurance carriers roll out system updates at different speeds, the beginning of the year often brings slower portals, longer phone waits, and a higher risk of denials if coding, documentation, or payer rules are not aligned.

Last Update: 12/22/2025

What’s Most Important for Offices to Know Right Now

New CDT codes are here, but coverage is not automatic.

New codes help practices document care more precisely, but each plan decides whether it is covered, downgraded, or patient responsibility. ADA News+1

Some codes were revised or deleted, and using old codes can trigger denials.

CDT 2026 includes revisions (including restorative and anesthesia-related updates) and deletions that affect clean claim submission. ADA News+

January processing is slower and more inconsistent, so verification and documentation matter more than ever.

Payers update systems in stages, and early-year eligibility and benefits can be incomplete, which makes careful verification and saved proof essential. ADA News+1

2026 CDT and Insurance Updates

Full Details, Office Impact, and FAQs

1) Summary of 2026 CDT Changes

CDT 2026 includes: 31 additions, 14 revisions, 6 deletions, and 9 editorial actions, with an effective date of January 1, 2026. Delta Dental+2ADA News+2
Practically, this impacts what your front desk verifies, what your clinical team documents, and how your billing team submits claims.

2) New Code Themes for 2026

The ADA highlighted several areas where new codes were added to better reflect what practices are already doing. ADA News

A. Point-of-care testing and diagnostics

Point-of-care saliva testing now has CDT support so offices can document in-office analysis more clearly. ADA News+1
There is also a new code for testing for a cracked tooth, designed to document comprehensive testing used to locate a crack and rule out look-alike conditions. ADA News+1

B. Prosthodontics, duplicates, and specialty prostheses

New codes address duplicate dentures (maxillary and mandibular) to clearly report backup dentures made using existing records or digital workflows. ADA News+1
There are also new codes related to guidance prostheses and resection prostheses that may matter for surgical and prosthetic cases. Delta Dental

C. Implant maintenance and peri-implantitis

A new code supports scaling and debridement for an implant affected by peri-implantitis without surgical flap entry and closure. ADA News+1
Some payer summaries also reference implant maintenance procedures tied to removal and reinsertion of full arch implant-supported prostheses. Delta Dental+1

D. Occlusal guards and adjunctive therapy

There is a code for cleaning and inspection of an occlusal guard, which helps practices document a common service more distinctly. ADA News+1
Photobiomodulation therapy appears in payer change summaries as new time-based reporting. Delta Dental

3) Revised and Deleted Codes That Can Affect Claims

The ADA has specifically called out revised codes that offices should understand before submitting 2026 claims. ADA News

Key revisions highlighted by ADA

D2391 (resin-based composite, one surface, posterior): the descriptor was revised to remove language that limited application based on lesion depth, making reporting more consistent. ADA News
D9230 (nitrous oxide administration): revised to clarify it is used when nitrous is delivered as a single agent, and it is part of broader anesthesia revisions. ADA News+1
D5876 (add metal substructure to acrylic complete denture, per arch): revised to clarify scope and use. ADA News+1

Deletions offices need to stop using for 2026 dates of service
Some payer summaries list deletions effective after 12/31/2025, including D1352 and certain vaccine administration and sedation-related codes. Delta Dental+1
Your billing team should make sure templates, fee schedules, and pick-lists do not default to deleted codes.

4) Insurance Reality Check for 2026

Even when CDT changes are universal, carrier behavior is not.

Carrier adoption timing varies. Some payers update portals, processing rules, and claim logic at different speeds, especially around January. Delta Dental
Coverage is plan-specific. A code can be valid and still be non-covered, downgraded, or placed into a different benefit category depending on the contract. Delta Dental
Payers may publish their own processing policies. Some carriers pair CDT 2026 changes with policy updates affecting perio evaluation and treatment, debridement, and ridge preservation grafting. Delta Dental

5) What Dentistry Support® Recommends for Every Office

These steps reduce denials and reduce confusion for patients.

Update software and claim templates
Ensure your practice management system is set to CDT 2026 and remove deleted codes from shortcuts. Delta Dental
Train your team on the “why” behind changes
If your front office understands what changed, they can explain estimates more clearly and prevent surprise patient balances.
Document like you are building an appeal from day one
Strong notes, attachments when needed, and saved benefit proof make a major difference when a payer changes processing rules midstream.

FAQs for Dental Offices

When do we start using CDT 2026 codes?
Use CDT 2026 for services performed on or after January 1, 2026. Delta Dental+1

Does a new CDT code mean insurance will pay for it?
Not automatically. CDT provides reporting standards, but coverage depends on the plan and payer policy. Delta Dental+1

Why do benefits and portals look “off” in January?
Many carriers update systems in phases, and early-year data can lag behind real plan rules, which is why reverification and documentation matter.

What happens if we submit a claim with a deleted code?
It can be denied, delayed, or kicked back for correction, which slows reimbursement and increases work for your team. Delta Dental+1

What code changes should my office pay closest attention to?
Anything tied to restorative coding, anesthesia reporting, implant maintenance, and diagnostic testing tends to impact payer logic and documentation expectations. ADA News+2ADA News+2

What is Dentistry Support doing differently in January and early 2026?
We monitor payer updates, verify benefits carefully, document proof of benefits, and support claim follow-up when processing is delayed.

Updated CDT and Insurance Changes Library

We maintain a frequently updated section of our website as new payer guidance is confirmed and as real-world claim trends appear. This page is designed to be a living resource for your team. Please check here for more details

(Note, this link is updated every Monday from October 2025 and forward with the most updated information available.)

Patient-Facing Script for January Appointments

You are welcome to copy and use this with patients:

“Because dental insurance resets at the beginning of the year, insurance companies update their systems in stages. We are actively verifying your benefits, but some information may take a little longer to fully confirm. Your final insurance estimate may be updated closer to your appointment once the insurance company finishes loading all plan details. We appreciate your patience as we work to make sure everything is accurate for you.”

Disclaimer

Insurance systems commonly experience delays and changes at the start of the year due to plan resets and staged updates. Preliminary checks completed in December do not replace January verification. Benefit information may change as carriers finalize data. Same-day verification delays are expected during the first weeks of January.

Billing & Claims FAQ

Dentistry Support® January 2026 Billing Protocol for clients enrolled in Billing Support.

Why does Dentistry Support avoid calling insurance carriers in early January?

The first 10 days of January bring extreme call volume, long hold times, and inconsistent information from carrier representatives. Calling during this period often results in incomplete or unreliable responses.

To maintain efficiency and accuracy, Dentistry Support does not perform claims research calls during the first 10 days of January unless a true exception is identified.

How is claims research handled during this period?

From January 1 through January 10, claims research is completed exclusively through insurance portals, including:

Claim status review
Claims resubmissions
Claims Appeals
Claims Adjudication

Portals update faster and more consistently than call centers during early January.

When do insurance calls resume?

Insurance calls regarding claims only resume after January 10, once carrier call volumes stabilize and representatives are more likely to provide accurate, updated information.

What happens if a claim is delayed during the first 10 days?

Claim delays during early January are expected. During this time, Dentistry Support will:

Monitor claim status through portals
Confirm correct CDT coding
Ensure documentation is complete
Flag claims for follow-up once calling resumes

No action is missed. Timing is strategic. We will continue to update you in our HIPAA Compliant Chat System. Please maintain communication with us there.

Are claims still being submitted during this time?

Yes. Claims are submitted using the most accurate information available through portals and documented verifications. Delayed processing does not mean delayed submission unless payer guidance requires it. Our team will continue to maintain daily claims submission, payment posting and claim updates.

Will claims be rechecked later?

Yes. Claims submitted or pending during early January are reviewed again once carrier systems stabilize. Rechecks help catch changes in benefits, deductible application, or processing logic. Our team already has mandatory overtime allocated (at no additional cost to your office) for January 11th and forward.

How does this protocol protect offices?

This approach:

Avoids unreliable carrier responses
Reduces unnecessary rework
Improves documentation accuracy
Prevents conflicting benefit information
Allows focused follow-up when it is most effective

What documentation supports claims during this time?

Dentistry Support maintains:

Portal screenshots and benefit records
Verification notes with date and time stamps
Saved proof of benefits
Clear claim submission records

This documentation supports follow-up and appeals if needed.

What should offices expect in early January?

Slower claim movement
Fewer real-time carrier answers
Portal-based status updates
Strategic follow-up beginning mid-January

This is standard industry behavior every year.

When does billing activity normalize?

Most billing activity stabilizes later in January, with improved turnaround times in February and more predictable trends by March.

Key January Billing Reminder

January billing is about timing and accuracy, not speed. Dentistry Support follows a deliberate protocol to protect reimbursement, reduce confusion, and support long-term claim success.