MedicaidCoverageMedium impact
2022 Dental Fee Schedule Update for CDT D1354 pdf
Connecticut Medicaid (HUSKY Health)·CT · Dentistry·Reimbursement
Effective date
Nov 1, 2022
We identified it
Jun 20, 2026
Summary
Connecticut expanded coverage for dental code D1354 (Interim Caries Arresting Medicament/Silver Diamine Fluoride) to all HUSKY Health members (children and adults) effective November 1, 2022. The policy removes prior authorization requirements and sets specific usage limits and billing requirements.
Action Required
Immediately for Connecticut dental providers: Update billing systems to include D1354 ($28.42 + $1.00 per tooth) for HUSKY A, B, C, and D members. Ensure fields 25 (oral cavity area) and 27 (tooth numbers) are completed on claims. Remove prior authorization requirements for D1354. Note usage limits: primary teeth every 4 months until exfoliation, permanent teeth maximum 6 times per lifetime every 4 months. If restoring SDF-treated teeth within 3 months, DSS will recoup D1354 fee.