Are molds of my teeth covered by insurance?
Usually no, unless the plan has orthodontic benefits, and even then the models are typically folded into the braces fee rather than paid on their own. Study models (code D0470) are plaster or digital copies of the teeth, made from an impression or a scan, that the dentist uses to plan braces, dentures, or a change to the bite.
Rarely
Ortho benefit or excluded
Ortho only
Where D0470 pays at all, it is usually inside orthodontic benefits, so a plan with no ortho rider pays nothing for models.
Inside the fee
On a braces case the models are part of the global fee (D8080 or D8090). Billing them separately is a denial waiting to happen.
Adult ortho gap
Many plans cut orthodontic benefits off in the late teens, which takes the models down with the braces. The age rule decides.
Rider or no rider
The eligibility check shows whether this plan carries orthodontic benefits, the age limit, and the percentages by category, before the impression is poured.
What would a real check show for this patient's D0470?
Pick a sample plan and type your fee. This is the visibility a real-time check gives the desk for every actual patient, in under a second.
Eligibility readout · D0470
Sample- Coverage
- Active, D0470 NOT a covered benefit
- Frequency
- Not a covered benefit; no ortho on plan
- Patient share
- Type your fee to see it
Estimate from a sample plan. A real check reads the actual plan in under a second.
When D0470 is the right code
- Models of the teeth for planning, not for making an appliance
- Planning braces, a denture, or a bite change
- Made from an impression or a digital scan
- Not the impression for a crown or night guard
Documentation payers expect
A note on what the models are for. On an ortho case, payers expect them inside the case fee; on a prosthetic or bite case, tie them to the treatment plan.
Why study models get denied
What happens after the study models
Models mean a big case is being planned: braces (D8080 for a teen, D8090 for an adult), a full denture (D5110), or a partial (D5213). Ortho is its own benefit with its own lifetime maximum and, on many plans, an age cutoff; dentures are major work, typically at 50% after a waiting period. The patient sees the models and starts asking what the whole thing costs. The desk that has the ortho benefit, the major percentage, and the waiting period on screen answers on the spot.
D0470, quick answers
Does insurance cover study models?
Rarely on their own. Most plans pay D0470 only as part of orthodontic benefits, and otherwise treat it as not covered.
Are the models included in the braces fee?
Typically, yes. Records, including models, are part of the global fee billed under D8080 or D8090, so a separate line usually denies.
What if the plan has no orthodontic coverage?
Then the models are patient portion. Quote them that way up front rather than waiting for the denial.
Do models for a denture or bite case pay?
Sometimes, when a treatment plan is attached. Many plans still bundle them into the denture or exclude them, so check the specific code first.
How do we know if this patient has ortho benefits?
The eligibility check shows whether orthodontic coverage exists on the plan, and the age limit, before the impression is taken.
More questions? Schedule 15 minutes with us and bring your toughest plan.
Every ortho consult, the ortho benefit known before the molds.
First month free, then $2.50 a check. No seat fees, no contract.
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CDT is maintained by the American Dental Association. This page is Valian's own plain-English summary for front-desk teams, not official CDT descriptor text, and is not billing or clinical advice. Coverage patterns are common plan behaviors; every plan differs. Verify benefits before treatment.