Section 17b-262-697 - Services covered and limitations(a)Services Covered(1) The department shall pay for medically necessary and medically appropriate public health dental hygienist services provided to clients subject to the limitations listed in subsection (b) of this section.(2) The department shall pay providers only for those procedures listed in the provider's fee schedule.(b)Limitations(1) Dental examination is limited to one (1) every six (6) calendar months per client.(2) The department shall not pay for fluoride treatment except for the following clients, and shall limit treatment to one (1) time every six (6) calendar months per client: (A) clients under age twenty one (21); and(B) clients over age twenty one (21):(i) using radiology services as oncology treatment on a regularbasis; or(ii) residing in nursing facilities or intermediate care facilities for the mentally retarded who have six (6) or more natural teeth.(3) Pit and fissure sealant is limited to: (A) clients between the ages of five (5) through sixteen (16), inclusive;(B) first and second permanent molars that are decay and restoration free; and(C) one every five (5) calendar years per tooth.(4) A public health dental hygienist who is salaried at a practice location shall not bill the department for dental hygienist services for clients seen at this location.(5) Payment for dental hygienist services is available to all clients who have a need for these services, subject to the limitations in this subsection, when provided at the following locations only:(D) a school that does not have a dental clinic on site;(E) a clinic or community health center that does not have a dental clinic on site; or(F) a hospital outpatient department that does not have a dental clinic on site.Conn. Agencies Regs. § 17b-262-697
Adopted effective July 10, 2001