FINANCIAL INFORMATION
We understand how confusing and time-consuming it can be to get insurance companies to cover treatment costs. We are here to help you as best we can so that you can anticipate your out-of-pocket expenses and expedite reimbursement from insurance companies. Please read the information carefully to avoid any confusion at the time of your visit.
ANTICIPATED FEES
CONSULTATION FEES:
The fee for a consultation is $150 for patients of all ages, regardless of whether you treat the same day or return for treatment another time. Consultation fees are not applied towards treatment.
TREATMENT FEES:
Babies and Toddlers: The fee for a frenectomy is $849 per site. The tongue is considered a single site, and the upper lip and buccals (cheeks) are considered a separate site. Therefore, treating just a tongue tie would cost $849, and treating a tongue and lip (with or without buccals) would be $1,698. There is no charge for follow-up visits. The maximum out-of-pocket treatment cost is $1,698, not including the $150 consultation.
Children (ages 4-17): The cost for a tongue tie release is $949 and a lip tie is $849. If we schedule treatment and your child is unable to begin the procedure, there will be a $150 office visit fee in lieu of treatment fees.​ If we begin the treatment and need to stop due to uncooperative or unsafe behavior, the full treatment fee will apply.
​
Adults (18+): The cost for a tongue tie release is $949 and a lip tie is $849. If a Cone Beam CT scan (CBCT) is required due to symptoms suggestive of airway obstruction, sleep apnea, or jaw size concerns, the cost of a CBCT is $499.
​
Payment is due at the time of service, and your insurance company should reimburse you directly if treatment is covered (if they send us reimbursement, we will refund your credit card or issue a refund check the same day we receive it.) See below for more information about insurance coverage.
Please note: Payment plans are not available for tongue tie treatments.
​
​
INSURANCE
Dr. Aaronson is an out-of-network provider for all dental and medical insurance. This means that your insurance may not cover any treatment if your policy does not cover non-contracted providers. However, we have found that most medical and dental insurances will still reimburse some of the treatment fees (and in some cases the entire amount).
In order to best anticipate your financial responsibility, you should contact your medical and/or dental insurance provider directly in advance. When you call your insurance company, please be sure to inform them that you are seeing an out-of-network dental provider. Please note: some insurance companies require pre-authorization, in which case we would need to submit paperwork, including photos, prior to any treatments.
We will provide you with a superbill and all the forms necessary to submit for reimbursement from your medical insurance, however we are no longer able to submit medical claims on your behalf. We will, however, submit a dental claim if your child is on your dental insurance, even though coverage would still be based on whether you have out-of-network coverage.
Payment in full is due at the time of service,
regardless of insurance coverage.
​
The procedure codes are as follows
-
Medical Insurance:
-
CONSULTATION, $150. CPT code 99245
-
CONE BEAM CT SCAN, $499. CPT code 70486
-
LIP/CHEEK TIE, $849. CPT 40819; diagnosis code Q38.0
-
TONGUE TIE (infant), $849. CPT 41115; diagnosis code Q38.1
-
TONGUE TIE (child/adult), $949. CPT 41520; diagnosis code Q38.1
-
-
Dental Insurance:
-
CONSULTATION, $150. ADA code D9310
-
CONE BEAM CT SCAN, $499. ADA code D0383
-
LIP/CHEEK FRENECTOMY, $849. ADA code D7961
-
TONGUE FRENECTOMY (infant), $849. ADA code D7962
-
TONGUE FRENULOPLASTY (child/adult), $949. ADA code D7963
-
-
Dr. Aaronson's NPI: 1134375652
-
Office TIN: 99-3182430
Medical Reimbursement Forms
We will provide you with a superbill and invoice and a claim form to submit to your insurance for reimbursement (see below for links to download additional claim forms)
Please note: any fees not covered by insurance are your responsibility. Payment is due at the time of service, and any payments made by your insurance will be sent directly to you.
​
Medical Reimbursement Claim Forms (click to download):
INSURANCE INQUIRY SCRIPTS
Before You Call
​
Dr. Heidi Aaronson is an out-of-network provider for all dental and medical insurance plans.
This means your insurance company may or may not reimburse you, depending on your plan’s out-of-network coverage.
-
Our office does not bill medical insurance directly, but we provide a superbill and all necessary documentation so you can submit your claim.
-
We do submit dental claims for you, even though reimbursement still depends on your out-of-network benefits.
-
Full payment is due at the time of service, regardless of insurance coverage.
When You Call Your Insurance Company
​
👶 For Infants
“Hi, my name is [Parent Name], and I’m calling to ask whether my plan covers treatment with an out-of-network dental provider.
My baby is being evaluated by Dr. Heidi Aaronson, DMD in Wellesley, MA for lip and tongue tie releases that are affecting feeding.”
​
🧒 For Children
“Hi, my name is [Parent Name], and I’m calling to ask whether my plan covers treatment with an out-of-network dental provider.
My child is being evaluated by Dr. Heidi Aaronson, DMD in Wellesley, MA for lip and tongue tie releasesthat are affecting oral function, speech, and feeding.”
​
🧑 For Adults
“Hi, my name is [Patient Name], and I’m calling to check if my plan covers treatment with an out-of-network dental provider.
I’d like to confirm what coverage I might have for a frenuloplasty procedure performed by Dr. Heidi Aaronson, DMD in Wellesley, Massachusetts.”
​
Provider Information
​
Provider: Dr. Heidi B. Aaronson, DMD
Practice: New Generation Dental Center
Address: 1 Washington Street, Suite 306, Wellesley, MA 02481
Phone: (781) 431-9999 Fax: (781) 431-9195
NPI: 1134375652 TIN: 99-3182430
Status: Out-of-network provider
​
Questions to Ask Your Insurance Company
​
-
Do I have out-of-network coverage? (If yes, ask how reimbursement is calculated.)
-
What percentage of the fee will be reimbursed for out-of-network services?
-
What is my deductible, and has it been met?
-
Is there an annual maximum or visit limit for this type of service?
-
Do you require pre-authorization or pre-determination for these procedure codes?
-
What documentation is needed to process a claim (e.g., superbill, photos, narrative)?
-
What is the “allowable” or “recognized” amount for these codes?
-
Where should I send my claim for reimbursement?
Clinical Context and Medical Necessity
​
If asked why the procedure is being done, you can explain that it is medically necessary due to feeding or functional concerns.
​
👶 For Infants
​
“My baby has been diagnosed with oral restrictions (tongue and/or lip ties) that interfere with feeding.
Symptoms include difficulty latching, clicking or leaking while feeding, reflux or gassiness, long or inefficient feeds, poor weight gain, or maternal nipple pain. Our goal is to improve feeding efficiency, comfort, and weight gain.
Dr. Aaronson specializes in complete functional releases, including posterior tongue ties, using precise laser techniques that minimize bleeding and scarring.”
​
🧒 For Children & 🧑 Adults
​
“Dr. Aaronson provides frenuloplasty procedures with sutures to release oral restrictions that impact speech, swallowing, posture, breathing, and jaw or neck tension. These procedures are often considered medically necessary when functional limitations or discomfort are present.”
​
Why an Out-of-Network Specialist May Be Necessary
​
To the best of our knowledge, there are currently no local in-network providers (including ENTs, pediatricians, or oral surgeons) who have specialized training in performing complete tongue-tie releases, particularly those involving posterior restrictions.
​
Failure to see a provider with adequate training can result in:
-
Persistent symptoms due to incomplete release
-
Damage to salivary glands or nearby tissues
-
Excessive bleeding or scarring
-
The need for revision procedures
Dr. Aaronson has advanced training and experience in full functional releases that address both anterior and posterior components safely and completely.
​
Appeals and Out-of-Network Exceptions
If your insurance company says they do not cover out-of-network providers, ask about exceptions or appeals based on medical necessity and provider availability.
​
👶 For Infants
“There are no in-network ENTs, pediatricians, or oral surgeons who have training in performing complete infant tongue and lip tie releases, including posterior ties. Can an out-of-network exception be made so my child can receive appropriate treatment?”
​
🧑 For Children & Adults
​
“There are no in-network providers who perform posterior tongue-tie releases with sutures.
The procedure I am inquiring about is coded as D7963 (frenuloplasty) or CPT 41520, depending on whether it’s billed to dental or medical insurance.
Dr. Heidi Aaronson, DMD, is trained and experienced in performing these posterior releases using a surgical technique with sutures. Since there are no in-network providers with equivalent training or services, can an out-of-network exception or prior authorization be granted?”
​​
​Ask your insurance company:
-
Is there a process to request an out-of-network or gap exception?
-
What documentation is needed to request an exception or appeal?
-
Can my provider submit a letter of medical necessity?
-
If my claim is denied, what is the process for a written appeal?
Procedure Codes
The procedure codes are as follows
-
Medical Insurance:
-
CONSULTATION, $150. CPT code 99245
-
CONE BEAM CT SCAN, $499. CPT code 70486
-
LIP/CHEEK TIE, $849. CPT 40819; diagnosis code Q38.0
-
TONGUE TIE (infant), $849. CPT 41115; diagnosis code Q38.1
-
TONGUE TIE (child/adult), $949. CPT 41520; diagnosis code Q38.1
-
-
Dental Insurance:
-
CONSULTATION, $150. ADA code D9310
-
CONE BEAM CT SCAN, $499. ADA code D0383
-
LIP/CHEEK FRENECTOMY, $849. ADA code D7961
-
TONGUE FRENECTOMY (infant), $849. ADA code D7962
-
TONGUE FRENULOPLASTY (child/adult), $949. ADA code D7963
-
-
Dr. Aaronson's NPI: 1134375652
-
Office TIN: 99-3182430
​
Important Notes
-
Our office can assist you with itemized receipts and clinical documentation if needed.
-
We do not guarantee coverage or reimbursement, as all benefits are determined by your insurance carrier.
-
If your plan requires pre-authorization, please notify us before scheduling treatment.
-
Full payment is due at the time of service, regardless of insurance coverage.