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Welcome  » May 19, 2024 8:14 PM
Program Name: BadgerCare Plus and Medicaid Handbook Area: Dental
05/19/2024  

Prior Authorization : Services Requiring Prior Authorization

Topic #20437

Custom Preparation of Maxillofacial Prosthetics

ForwardHealth covers the custom preparation of maxillofacial prosthetics with PA when rendered in an office setting by oral surgeons, orthodontists, pediatric dentist or prosthodontists.

PA requests for custom preparation of maxillofacial prosthetics will be approved for members who meet medical necessity as determined by defect and prognosis.

 
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