MedicaidPrior AuthHigh impact
Changes to the Implementation of Prior Authorization for Oral and Maxillofacial Surgery Codes
Connecticut Medicaid (HUSKY Health)·CT · Oral & Maxillofacial Surgery, Dentistry·Prior Authorization
Effective date
Dec 1, 2016
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid is implementing prior authorization requirements for 46 oral and maxillofacial surgery codes effective December 1, 2016. All procedures performed in hospital operating rooms, ambulatory surgical centers, or requiring overnight admission must be pre-approved through Community Health Network of Connecticut.
Action Required
By December 1, 2016: Billing teams for oral and maxillofacial surgeons and hospital-based dental clinics must obtain prior authorization from Community Health Network of Connecticut before performing any of the 46 specified surgery codes. Submit PA requests by fax to (203) 265-3994 with required documentation including diagnostic imaging, cephalometric tracings, functional impairment descriptions, diagnostic testing, and facial photographs. Claims for these codes will be denied without prior authorization for Connecticut Medicaid patients.