5 - Variation in Teledentistry Regulation by State

Abstract: Objective: Teledentistry can be used to both improve access to and provide oral health services. Regulatory guidance during the COVID-19 pandemic facilitated the swift adoption and expansion of teledentistry. This study describes the state-to-state variability in rules for the use of teledentistry in 2022.
Methods: Researchers reviewed state laws and regulations to gather information on the source of regulatory authority for teledentistry, types of allowable services, required methods, use of alternative methods, permitted providers, requirement for patient consent, requirement to be a patient of record, and Medicaid reimbursement for teledentistry codes in June-July 2022.
Results: The use of teledentistry was directly addressed in the Dental Practice Act or in dental regulation in 22 states. Teledentistry was permitted in more general telehealth/telemedicine statutes or regulations in 16 states and DC and through dental board directives or Medicaid regulation/directive/opinions in 8 states. Four states had no enabling legislation for teledentistry. Both synchronous and asynchronous teledentistry were allowed in 41 states; 6 states and DC allowed only synchronous teledentistry. In 12 states and DC, only dentists were permitted to provide teledentistry services, while 34 states permitted both dentists and dental hygienists to do so. Medicaid reimbursement for specific teledentistry codes was enabled in 14 states although many others reimbursed for limited examinations using teledentistry.
Conclusions: There is considerable variability in regulation of teledentistry by states. Regulatory clarity and expanded authority along with reimbursement reform is crucial for adoption and expansion of care delivery through teledentistry.

Source of Funding: US Health Resources and Services Administration, National Bureau for Health Workforce Analysis