ForwardHealth Covers Dental Case Management for Members With Special Health Care Needs
Beginning October 1, 2026, ForwardHealth covers dental case management for members with special health care needs, reimbursed under CDT code D9997 at $100 per visit. Prior authorization is required for more than one visit per member within 180 days, for D9997 billed with moderate to deep dental sedation in that period, for a member whose diagnosis is not a qualifying code but has documented medical necessity, and when the place of service is 15 (Mobile Unit). Prior authorization is not required for the first visit per member, per provider, every six months (180 days).