The CDT codes for virtual dental consultations are D9995 for synchronous visits (live video, real-time) and D9996 for asynchronous visits (store-and-forward: the patient uploads photos and answers questions, you review and respond later). Most medical and dental plans still don't reimburse either code reliably, so the workable model for most practices is to bill the visit as a self-pay teledentistry fee of $35 to $75, collected at submission, and apply it toward treatment if the patient books. That distinction — coded correctly, priced honestly, collected up front — is what turns virtual consults from a courtesy into a line item on your production report.
The free advice you're already giving away
Every practice already does this work. A patient texts a photo of a chipped tooth. A prospective implant patient calls asking whether they're a candidate before they'll book. A nervous new patient wants to "just talk to the dentist first." Right now that's a five-minute phone call your front desk interrupts you for, unbilled, unscheduled, and undocumented. Virtual consultations take that exact same clinical judgment call and route it through a structured, paid workflow instead: patient uploads photos and a short history through a link, it lands in a queue, you review it on your own schedule, and the response — with a recommendation and next steps — goes back to the patient with a fee attached.
Nothing about the clinical content changes. What changes is that it's documented, billed, and converts into a scheduled visit instead of evaporating as goodwill.
CDT Code for a Virtual Dental Consult: D9995 vs. D9996
D9995 covers synchronous teledentistry — a live video call where you and the patient are both present in real time. D9996 covers asynchronous teledentistry — the patient submits photos, a symptom description, and history, and you review and respond without a live session. For the workflow described in this post, D9996 is almost always the correct code, because the value is precisely that neither of you has to be available at the same moment.
In practice, submit the code for documentation and claims history, but don't build your fee schedule around getting paid by the plan. Coverage for D9996 varies enormously by state Medicaid program and by individual commercial plan, and even where it's technically covered, reimbursement is often $15–$25 — not enough to justify chair time you're not even using. The workable approach:
- Charge a flat self-pay virtual consult fee, collected by card at the time the patient submits photos.
- Submit D9996 to the plan anyway if the patient has coverage, and refund the difference if it pays.
- Credit the full fee toward treatment if the patient books a procedure within 30–60 days.
This keeps the fee simple to explain, avoids a billing dispute over a code most front desk staff have never submitted before, and means you get paid regardless of what the plan decides to do with the claim.
The between-patient math
The reason this works financially is that the review happens in minutes you're already losing — the two or three minutes between patients while the room is being turned over, or the ten minutes at the end of a block before your next patient is seated.
Time math: A photo-based async review — chart the images, read the patient's description, dictate or type a two-sentence recommendation — takes about 4 to 6 minutes once you're used to the format. At 5 consults reviewed per clinical day, that's 25 minutes of your time, absorbed into existing gaps rather than added to the schedule.
Money math: 5 consults/day x $49 fee = $245/day. Over a 20-day clinical month, that's $4,900 in fee revenue that didn't exist before — before counting a single case that converts to treatment. If even 40% of those convert to a booked exam or procedure (a conservative, industry-typical range for warm, pre-qualified virtual leads), and average first-visit production per converted case is $350, that's 2 conversions/day x $350 x 20 days = $14,000/month in additional booked production, on top of the consult fees themselves.
Those numbers move with your fee, your case mix, and your no-show rate — run them against your own schedule before you commit to a price. What doesn't move is the underlying mechanism: work that used to be a free phone call is now billed, documented, and feeds your schedule instead of just your reputation.
Building the workflow into your day, not on top of it
The failure mode for virtual consults is treating them like a new appointment type that has to be scheduled, staffed, and defended on the calendar. That's what kills adoption — most dentists try it for two weeks, find it adds friction, and quietly stop. The fix is to treat it as an inbox, not an appointment.
- A dedicated link on your website and in your automated patient communication sequence lets patients submit photos and a short questionnaire any time, day or night.
- Submissions queue by urgency (a broken tooth sorts ahead of a cosmetic question) instead of by arrival time.
- You clear the queue in the gaps you already have — between patients, at lunch, at the end of the day — rather than on a fixed schedule.
- Your response, and the patient's follow-up questions, get logged automatically, so there's a record if the case ever needs a hard copy for insurance or referral.
Because AI clinical notes already draft your documentation for in-office visits, the same structured note format extends naturally to virtual reviews — you're not inventing a separate charting habit for a handful of teledentistry cases a week.
Turning reviews into booked production
The revenue isn't really in the $49 fee — it's in what the fee buys you: a warm, pre-qualified patient who has already shown you their mouth, told you what's bothering them, and paid something to get your opinion. That patient converts at a much higher rate than someone calling cold, because they've already invested time and money before they ever sit in the chair.
Two patient segments convert especially well:
- Out-of-area patients relocating, snowbirding, or shopping for a second opinion on a treatment plan from another office — they need certainty before they'll drive or fly in, and a paid virtual review gives them that without you giving away a full workup for free.
- Anxious patients who won't call and won't walk in cold but will upload three photos and type out what's worrying them — the async format removes the social pressure of a live call and gets them talking.
Once a virtual consult converts, automatic insurance verification with per-procedure dollar estimates means the patient can see a real out-of-pocket number for the recommended treatment before their first visit, which shortens the conversation at check-in and lifts same-visit case acceptance instead of adding another round of "let me check with insurance and call you back."
If you're weighing whether to add this to your practice, the honest comparison is against what you're doing today: giving the same clinical opinion away over the phone, undocumented, unpaid, and with no structured path back to a booked appointment. You can see how the workflow, fee handling, and PMS sync fit together on the virtual consultations page, check current plans on pricing, or schedule a demo to walk through your own numbers before deciding on a fee.