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2024.08 - Provider Bulletin Clarifying Billing Guidance for Periodontal Services PDF

Connecticut Medicaid (HUSKY Health)·CT · Dentistry·Provider Bulletin
Effective date
Feb 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut HUSKY Health (Medicaid) has clarified billing guidance for periodontal services, specifying when to use D0150 vs D0180 evaluation codes and reinforcing that periodontal benefits are only available for patients with qualifying medical conditions listed in PB 2023-69. Providers must use the CTDHP prior authorization tool to verify patient eligibility before performing periodontal evaluations.

Action Required

Action needed
Immediately: Dental providers must verify patient eligibility using the CTDHP prior authorization tool before performing D0180 periodontal evaluations. Update billing procedures to ensure D0150 and D0180 are never billed together on the same date of service. Train staff that D0150 is limited to once per lifetime for patients 21+ and D0180 is only for patients with qualifying medical conditions from PB 2023-69. Do not perform or bill D0180 if your practice will not be providing the actual periodontal treatment.

Affected Billing Codes

D0150
D0180