You can immediately access the current Cigna Dental Clinical Coverage Determination Guidelines, which can guide you through benefit determination policies. They can be located on CignaforHCP.com > Resources > Reference Guides, as well as in the Resources section at the bottom of the Homepage of the Dental Digital Provider Newsroom.
The 2026 versions of the DHMO and DPPO documents will be available after 01/01/2026.
There are no adverse material changes to the determination guidelines for 2026.
However, multiple policies have been updated with various coverage clarifications and edits. These updates include any CDT 2026 updates.
Updates will include the following:
DHMO
- Descriptor updates to PREV-01, PERIO-01 and 06, OS-03, 04, 05, 06, 07, 08, and 09, ADJ-01 and 02
- Additional clarification of existing requirements added to policy OS-01.
- Additional clarification of existing requirements was added to policies PERIO-01 and 06, IMPLNT-01, OS-03, 04, 05, 06, 07, 08, 09, and 10.
- Minor grammatical corrections throughout.
DPPO
- Updates to REST-02, REST-03, REST 05, REST-07 to add an existing additional not allowable condition: “When placed solely for tooth structure loss due to wear, grinding, and/or erosion in the absence of symptoms.”
- Additional clarification of existing requirements added to policies: PERIO-10, PERIO-11, PERIO-13, PERIO-14, PERIO-15, PERIO-17, IMPLNT-05, IMPLNT-06, IMPLNT-07, IMPLNT-08, IMPLNT-11, IMPLNT-13, OS-02, OS-03, OS-04, OS-13, & ADJ-02
- Minor grammatical corrections throughout.
You may also request this information by contacting Customer Service at 800.Cigna24 (800.244.6224). A copy will be provided to you or your authorized representative free of charge.