MedicaidAdministrativeMedium impact
Transition to the Updated ADA 2012 J434 Dental Claim Form
Connecticut Medicaid (HUSKY Health)·CT · Dentistry, Oral & Maxillofacial Surgery·Coding
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) is transitioning to the updated ADA 2012 J434 dental claim form. Dental providers submitting claims to Connecticut Medicaid must begin using the new form version for all dental claims.
Action Required
Dental billing teams in Connecticut must obtain and implement the updated ADA 2012 J434 dental claim form for all HUSKY Health Medicaid submissions. Update billing software to use the new form format and train staff on any form changes. Contact HUSKY Health for specific implementation timeline and form requirements.