Policy on Third-party Reimbursement for Management of Patients with Special Health Care Needs

Purpose

The American Academy of Pediatric Dentistry (AAPD) recognizes that, because of improvements in medical care, the number of patients with special health care needs (SHCN) will continue to grow. Many of the formerly acute and fatal diagnoses have become chronic and manageable conditions. Patients with SHCN require a dental team with special knowledge and skills and additional staff time to coordinate care and/or accommodate the patient’s unique circumstances. An increased appointment length often is necessary in order to treat the patient in a safe, effective, and high-quality manner. Such customized services have not been reimbursed by third-party payors. AAPD advocates reimbursement for measures that are necessary to manage the patient’s unique healthcare needs within the dental home.