CSHCN 2008 > Dental > Benefits and Limitations

13.3.4.2 Authorization Requirements

Prior authorization requirements for specific procedures are contained in the individual sections. Prior authorization is valid up to 90 days. To obtain prior authorization, the following must be submitted:

•The CSHCN Services Program Prior Authorization Request for Dental or Orthodontia Services form.

•Provider documentation supporting the medical necessity and appropriateness of the recommended treatment.

Additional documentation, including current periapical radiographs, must be maintained in the client's medical record and submitted to the CSHCN Services Program on request.