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Provider Bulletin - Billing Updates for Dental T1015 Encounter Codes - 06.24.2022
Connecticut Medicaid (HUSKY Health)·CT · Dentistry·Provider Bulletin
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Connecticut FQHCs must now bundle all routine dental services (exam, prophylaxis, fluoride, radiographs) into a single visit when billing T1015 encounter codes. Splitting these services across multiple visits is prohibited unless medically necessary and documented.
Action Required
By July 1, 2022: FQHCs must update scheduling protocols to bundle all routine dental services (exam, prophylaxis, fluoride treatments, radiographs) into single appointments when billing T1015. Update billing system to prevent unbundling of these services. Staff must document medical necessity for any exceptions and request Post-procedure Review (PR). Failure to comply will result in claim denials and audit findings.