Title 33, Chapter 29, Section 20
(a) As used in this Code section, the term:
(1) "Functional deformity" means a deformity of the bone or joint
structure of the maxilla or mandible such that the normal
character and essential function of such bone structure is
(2) "Policy" means any major medical benefit plan, contract, or
policy except the Georgia Basic Health Plan, a credit insurance
policy, disability income policy, specified disease policy,
hospital indemnity policy, limited accident policy, or other
similarly limited accident and sickness policy.
(3) "Temporomandibular joint" means the connection of the mandible
and the temporal bone through the articular disc surrounded by the
joint capsule and associated ligaments and tendons.
(4) "Temporomandibular joint dysfunction" means congenital or
developed anomalies of the temporomandibular joint.
(b) No policy may be issued or issued for delivery in this state
(1) Excludes medically necessary surgical or nonsurgical treatment
for the correction of temporomandibular joint dysfunction by
physicians or dentists professionally qualified by training and
(2) Excludes medically necessary surgery for the correction of
functional deformities of the maxilla and mandible.
(c) The provisions of this Code section shall not cover cosmetic or
elective orthodontic or periodontic care or general dental care.
(d)(1) The coverage under paragraph (1) of subsection (b) of this
Code section may contain such types of exclusions, reductions, or
other limitations as to coverages, deductibles, or coinsurance
provisions which apply to other benefits under the accident and
sickness insurance benefit plan, policy, or contract.
(2) Basic coverage for the nonsurgical treatment of
temporomandibular joint dysfunction under paragraph (1) of
subsection (b) of this Code section may be limited to history and
examination; radiographs, which must be diagnostic for
temporomandibular joint dysfunction; splint therapy with necessary
adjustments, provided that removable appliances designed for
orthodontic purposes would not be reimbursable under a major
medical plan; and diagnostic or therapeutic masticatory muscle and
temporomandibular joint injections.
(e) Except as provided in paragraph (1) of subsection (c) of Code Section 33-30-23, for policies limited only to dental coverage, nothing contained in this Code section shall be deemed to prohibit the payment of different levels of benefits or from having differences in coinsurance percentages applicable to benefit levels for services provided by preferred and nonpreferred providers as otherwise authorized under the provisions of Article 2 of Chapter 30 of this title, relating to preferred provider arrangements.