MedicaidPrior AuthMedium impact
Clarification of Provider Bulletin 2022.45 - Billing Updates for Dental T1015 Encounter Codes pdf
Connecticut Medicaid (HUSKY Health)·CT · Dentistry·Provider Bulletin
Effective date
Sep 1, 2022
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY) clarifies that FQHC dental clinics must bundle periodic dental visit services (exam, prophylaxis, fluoride, radiographs) into one appointment unless medical necessity requires splitting into two visits, which requires Post Procedure Review approval from BeneCare Dental Plans.
Action Required
Immediately: FQHC dental billing teams must ensure periodic dental visits are scheduled as bundled appointments including exam, prophylaxis, fluoride treatments, and radiographs. If medical necessity requires splitting services across two visits, document medical reasons clearly in patient chart and submit Post Procedure Review request to BeneCare Dental Plans via www.ctdhp.com or mail to Prior Authorization Unit, BeneCare Dental Plans, P.O. Box 40109, Philadelphia, PA 19106-0109. Claims for second visits will be denied without PPR approval.