Temporalmandibular Joint Syndrome Treatment

Treatment of temporalmandibular joint (TMJ) syndrome, occlusal equilibration and restorative occlusal rehabilitation are excluded. Treatment of acute (not chronic) myofacial/TMJ pain may be covered; care of these patients is subject to additional restrictions and guidelines:

• Treatment of this syndrome may be considered a medical problem only when it involves immediate relief of pain.
• Emergency treatment may include initial radiographs, up to four office visits and the construction of an occlusal splint, if necessary to relieve pain and discomfort.
• Treatment beyond four visits, or any repeat episodes of care within a period of six months, must receive individual consideration and be documented by the provider of services.

If covered, the type of location where the services are rendered will determine costs; outpatient office setting, ambulatory surgery setting or inpatient hospital setting.