CSHCN Services Program 2010 > Dental > Benefits, Limitations, and Authorization Requirements

14.2.6.2 Authorization and Prior Authorization Requirements

All inpatient hospital admissions for dental services require prior authorization. Except for those specific procedures that require prior authorization, admission to freestanding ASCs or outpatient hospital ambulatory surgical centers (HASCs) for the purpose of performing dentistry services require authorization.

The CSHCN Services Program Criteria for Dental Therapy Under General Anesthesia form must be submitted to the TMHP-CSHCN Services Program with supporting documentation of medical necessity.

Refer to: Chapter 4, "Authorizations and Prior Authorizations" for additional information.

Chapter 23, "Hospital".

Appendix B, "CSHCN Services Program Prior Authorization Request for Inpatient Hospital Admission-For Use by Facilities Only" and for Appendix B, "CSHCN Services Program Prior Authorization Request for Inpatient Surgery-For Surgeons Only" for the prior authorization form.