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Adult Dental Fee Schedule Composite Restorations on Molar Teeth pdf

Connecticut Medicaid (HUSKY Health)·CT · Dentistry·Reimbursement
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY A, C, D) will now cover composite resin restorations on posterior molar teeth (teeth 2, 3, 14, 15, 18, 19, 30, 31) as an alternative to amalgam fillings. Four new CDT codes (D2391-D2394) are added with specific reimbursement rates ranging from $49.40 to $104.00.

Action Required

Action needed
Effective July 1, 2019: Dental billing team must add CDT codes D2391 ($49.40), D2392 ($59.28), D2393 ($75.40), and D2394 ($104.00) to billing system for composite resin restorations on molar teeth 2, 3, 14, 15, 18, 19, 30, 31 for Connecticut Medicaid patients. Update fee schedules and ensure providers do not bill partial restorations with plans to complete within 6 months on same tooth.

Affected Billing Codes

D2391
D2392
D2393
D2394