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Update to the Dental Fee Schedule Cone Beam Computed Tomography Imaging pdf

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

Summary

Connecticut Medicaid (HUSKY) now requires prior authorization for all Cone Beam CT imaging services effective July 1, 2019, with expanded billing codes D0364-D0368. Post-procedure review is only allowed for facial trauma cases.

Action Required

Action needed
Immediately for Connecticut providers: Update billing system to require prior authorization through CTDHP (1-888-445-6665) before performing any CBCT imaging for HUSKY members using codes D0364-D0368. Document medical necessity and include previous images with PA requests. Exception: Post-procedure billing allowed only for facial trauma cases. Claims without prior auth will be denied.

Affected Billing Codes

D0364
D0365
D0366
D0367
D0368
Update to the Dental Fee Schedule Cone Beam Computed Tomography Imaging pdf | Connecticut Medicaid (HUSKY Health) | PolicyChanges.app