Notices & Updates

Dental Fee Schedule

You can access the Fee Schedule Lookup tool in the Provider Portal under either Quick Access or the Resources menu.

If you have any questions, please contact us via the Message Center in the Provider Portal.

9/09/26

Taxonomy Code Required on All Claims

All electronically submitted claims must include the provider’s taxonomy code to be processed correctly. Claims missing a taxonomy code will be denied.

Taxonomies power the fee schedule that is used to process and pay claims. If the taxonomy billed on a claim differs from what PEHP has on file, the claim may be processed under a different fee schedule, which could result in reduced reimbursement.

To prevent payment issues:

• Review and confirm that the taxonomy billed on all claim forms matches the one on file with PEHP.
• If an update is needed, complete the Provider Account Information Form to request a change.
• Notify your clearinghouse that your taxonomy code is required for submitting claims to PEHP.

If you have any questions, please contact us via the Message Center in the Provider Portal.

9/09/26

CDT Dental Code Guide

The CDT Dental Code Guide is intended to assist providers in verifying CDT code descriptions, frequency limitations, claim remark requirements, policy guidelines, and pre‑service preauthorization requirements. It does not outline member benefits, yearly maximums, waiting periods, or other plan‑specific provisions. The inclusion of a CDT code does not guarantee that the service is eligible for coverage. Coverage and eligibility vary by plan; providers should confirm both prior to delivering services.

If you have any questions, please contact us via the Message Center in the Provider Portal.

9/09/26

Changes starting January 1, 2026

Please review the key changes below and plan accordingly to avoid delays:

What’s changing?

• Dental preauthorization (PA) required for certain procedures. See list.
• Electronic claims encouraged (see how).
• Electronic payments encouraged (see how to sign up for EFT). 

Why the changes?

• Ensure medical necessity and prevent service duplication: Our new system is programmed to automatically detect and verify PA requirements during claim processing.
• Faster claims processing: Our upgraded auto-adjudicating system processes clean claims in less than 10 days.
• Streamline payments: Paper checks create unnecessary administrative burdens for everyone – switching to EFT ensures you get paid faster.

If you have any questions or need support with these changes, please contact us via the Message Center in the Provider Portal or call 801-366-7555.