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Treatment Planning and Radiographic Imaging Requirements pdf
Connecticut Medicaid (HUSKY Health)·CT · Dentistry·Provider Bulletin
Effective date
Sep 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) now requires dental providers to submit comprehensive treatment plans with radiographic imaging for any patient needing multiple endodontic, crown, or prosthodontic procedures. All radiographs must meet specific quality standards and be properly labeled, or they will be rejected and recouped.
Action Required
Immediately for Connecticut dental providers: Submit treatment plans with complete radiographic series (D0210, D0330, D0270-D0274) for all HUSKY Health members requiring multiple endodontic, crown, or prosthodontic procedures via electronic PA system at www.ctdhp.org or mail to Prior Authorization Unit, C/O Bene Care Dental Plans, P.O. Box 40109, Philadelphia, PA 19106-0109. Ensure all radiographs are properly labeled with patient name, date, and mounted correctly. Non-diagnostic or improperly labeled radiographs will be rejected and may result in recoupment.