Prime Remote Handbook

Active duty service members enrolled in TPR are automatically covered by the Tri-Service Remote Dental Program (RDP). The RDP is administered by the Military Medical Support Office (MMSO), and all dental prior authorization requests, claims, and other inquiries are handled through your service point of contact (SPOC).

There is no preferred dental network for the RDP, so you may choose any licensed dentist in your area. MMSO does not maintain a list of preferred dentists.

Emergency dental care does not require prior authorization and includes any treatment necessary to relieve pain, treat infection*, control hemorrhage, or repair broken fillings—including placement of temporary or permanent fillings (not crowns).

Crowns, bridges, and dentures are not considered emergency care and do require prior authorization (see “Dental Services Requiring Prior Authorization ” later in this section).

For example, root-canal therapy required to relieve pain or treat infection can be completed without prior authorization even if this treatment requires more than one appointment. If the need for a crown is indicated following the root canal therapy, the crown must have prior authorization before initiating the crown preparation.

1. The individual procedure cost and total cost of treatment for that day must be less than $500 to be considered routine care. For example, two or three fillings or extraction of one or two teeth is considered to be routine care as long as the total cost is less than $500 for that appointment.
    
2. After total treatment costs for a calendar year reach $1,500, all subsequent care must have prior authorization including routine care.
    
3. The procedures must be covered benefits. (See the section about “Dental Services Not Covered by the RDP.”)

Example: If the total cost of any nonemergency treatment for any one procedure or appointment will exceed $500 (such as most multiple wisdom tooth extractions), you must have written pre-authorization from MMSO before initiating the treatment. If the expected cost of dental treatment will exceed the $1,500 amount for the calendar year, you must obtain pre-authorization prior to initiating the treatment.

Note: Crowns are not considered routine care under any circumstances. Any nonemergency surgical procedure is considered to be specialty care and needs to have prior authorization, regardless of cost.

Extensive routine care, all specialty care (prosthodontics, periodontics, multiple extractions, or other oral surgery), and other dental treatment not considered emergency or routine care as defined in the previous sections is considered specialty care and requires prior authorization. Initiating specialty care without written prior authorization from MMSO may result in you being responsible for part or all of the cost of treatment.

Crowns requested for root-canal-treated teeth require the submission of a post-treatment periapical radiograph showing the completed root canal.

   
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