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Oral Health Assessment & Fluoride Varnish Services at Well-Child - Access to Baby Care Program pdf

Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Pediatrics, Internal Medicine +1 more·Provider Bulletin
Effective date
Sep 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY Health) updated billing codes and reimbursement for oral health assessments and fluoride varnish services provided by non-dental medical providers to children under 7. Medical providers must complete certification training to bill these services with specific E/M codes plus modifier DA for oral assessments ($25) and CPT 99188 for fluoride varnish ($20).

Action Required

Action needed
For Connecticut practices treating HUSKY Health members: Eligible physicians, PAs, and APRNs must complete free CTDHP certification training before billing oral health services. Update billing system to use modifier DA with E/M codes (99202-99205, 99211-99215, 99381-99383, 99391-99393) for oral assessments and CPT 99188 for fluoride varnish for children under 7. Retain CEU documentation. Claims will be denied without proper certification.

Affected Billing Codes

99202
99203
99204
99205
99211
99212
99213
99214
99215
99381
99382
99383
99391
99392
99393
99188
Z91.841
Z91.842
Z91.843