Skip to main content
  • This page, Dental Transmittal Letters, is   offered by
  • MassHealth

Dental Transmittal Letters

Transmittal letters contain changes to MassHealth provider manuals. They summarize the change, contain revised pages for the provider manual, and tell providers how to update their manuals with the new pages.

Skip table of contents
You skipped the table of contents section.
Open PDF file, 570.87 KB,  DEN-114: 2024 Updates to Subchapter 6 (English, PDF 570.87 KB)

Open DOCX file, 212.82 KB,  DEN-114: 2024 Updates to Subchapter 6 (English, DOCX 212.82 KB)

Open PDF file, 487.35 KB,  DEN-113: Updates to Subchapter 6 (English, PDF 487.35 KB)

Open DOCX file, 173.8 KB,  DEN-113: Updates to Subchapter 6 (English, DOCX 173.8 KB)

Open PDF file, 466.92 KB,  DEN-112: Updates to Subchapter 6 (English, PDF 466.92 KB)

Open DOCX file, 207.15 KB,  DEN-112: Updates to Subchapter 6 (English, DOCX 207.15 KB)

Open PDF file, 964.75 KB,  DEN-111: Dental Manual (Updates to 130 CMR 420.000, Subchapter 6, Appendix D, and Appendix F) (English, PDF 964.75 KB)

Open DOCX file, 301.13 KB,  DEN-111: Dental Manual (Updates to 130 CMR 420.000, Subchapter 6, Appendix D, and Appendix F) (English, DOCX 301.13 KB)

Open PDF file, 314.01 KB,  DEN-110: 2021 Updates to Subchapter 6 (English, PDF 314.01 KB)

Open DOCX file, 132.57 KB,  DEN-110: 2021 Updates to Subchapter 6 (English, DOCX 132.57 KB)

Open PDF file, 702.3 KB,  DEN-109: Expanded Coverage of Adult Dental Benefits (English, PDF 702.3 KB)

Open DOCX file, 137.78 KB,  DEN-109: Expanded Coverage of Adult Dental Benefits (English, DOCX 137.78 KB)

Open PDF file, 110.88 KB,  DEN-108: Revised Appendix D (English, PDF 110.88 KB)

(January 2021)

Open DOCX file, 100.72 KB,  DEN-108: Revised Appendix D (English, DOCX 100.72 KB)

(January 2021)

Open PDF file, 284 KB,  DEN-107: Revision to Subchapter 6 (English, PDF 284 KB)

Open DOCX file, 144.72 KB,  DEN-107: Revision to Subchapter 6 (English, DOCX 144.72 KB)

Open PDF file, 302.39 KB,  DEN-106: Updates to Appendix D (English, PDF 302.39 KB)

(June 2020)

Open DOCX file, 126.24 KB,  DEN-106: Updates to Appendix D (English, DOCX 126.24 KB)

(June 2020)

Open PDF file, 451.25 KB,  DEN-105: Revision to the Subchapter 6 (English, PDF 451.25 KB)

Open DOCX file, 177.43 KB,  DEN-105: Revision to the Subchapter 6 (English, DOCX 177.43 KB)

Open PDF file, 269.25 KB,  DEN-104: Revised Appendix D (English, PDF 269.25 KB)

(March 2020)

Open DOCX file, 163.74 KB,  DEN-104: Revised Appendix D (English, DOCX 163.74 KB)

(March 2020)

Open PDF file, 314.62 KB,  DEN-103: Update to Subchapter 6 (English, PDF 314.62 KB)

Open DOCX file, 143.97 KB,  DEN-103: Update to Subchapter 6 (English, DOCX 143.97 KB)

Open PDF file, 113.28 KB,  DEN-102: Updates to 130 CMR 420.000 and Subchapter 6 (English, PDF 113.28 KB)
Open DOCX file, 19.83 KB,  DEN-102: Updates to 130 CMR 420.000 and Subchapter 6 (English, DOCX 19.83 KB)
Open PDF file, 82.08 KB,  DEN-101: Revised Service Codes (English, PDF 82.08 KB)
Open DOCX file, 17.99 KB,  DEN-101: Revised Service Codes (English, DOCX 17.99 KB)
Open PDF file, 108.85 KB,  DEN-100: Updates to 130 CMR 420.000: Dental Services (English, PDF 108.85 KB)
Open DOCX file, 171.09 KB,  DEN-100: Updates to 130 CMR 420.000: Dental Services (English, DOCX 171.09 KB)
Open PDF file, 81.78 KB,  DEN-99: Orthodontic Treatment Visits (English, PDF 81.78 KB)
Open DOCX file, 19.86 KB,  DEN-99: Orthodontic Treatment Visits (English, DOCX 19.86 KB)
Open PDF file, 173.04 KB,  DEN-98: Orthodontic Treatment Visits (English, PDF 173.04 KB)
Open DOCX file, 19.82 KB,  DEN-98: Orthodontic Treatment Visits (English, DOCX 19.82 KB)
Open PDF file, 86.68 KB,  DEN-97: Updates to 130 CMR 420.000: Dental Services, Subchapter 6, and new Appendices E and F (English, PDF 86.68 KB)
Open DOCX file, 19.92 KB,  DEN-97: Updates to 130 CMR 420.000: Dental Services, Subchapter 6, and new Appendices E and F (English, DOCX 19.92 KB)
Open PDF file, 181.94 KB,  DEN-96: Revised Appendix D (English, PDF 181.94 KB)
Open DOC file, 194.5 KB,  DEN-96: Revised Appendix D (English, DOC 194.5 KB)
Open PDF file, 82.39 KB,  DEN-95: Revised Service Codes (English, PDF 82.39 KB)
Open DOCX file, 19.93 KB,  DEN-95: Revised Service Codes (English, DOCX 19.93 KB)
Open PDF file, 223.34 KB,  DEN-94: Revised Appendix G (English, PDF 223.34 KB)
Open DOC file, 303 KB,  DEN-94: Revised Appendix G (English, DOC 303 KB)
Open PDF file, 82.46 KB,  DEN-93: Revised Service Codes (English, PDF 82.46 KB)
Open DOCX file, 19.88 KB,  DEN-93: Revised Service Codes (English, DOCX 19.88 KB)
Open PDF file, 83.25 KB,  DEN-92: Revised Regulations and Service Codes (English, PDF 83.25 KB)
Open DOCX file, 19.88 KB,  DEN-92: Revised Regulations and Service Codes (English, DOCX 19.88 KB)
Open PDF file, 63.32 KB,  DEN-91: Revised Regulations about Dental Sealants (English, PDF 63.32 KB)
Open TXT file, 8.56 KB,  DEN-91: Revised Regulations about Dental Sealants (English, TXT 8.56 KB)
Open PDF file, 83.97 KB,  DEN-90: Revised Regulations and Updates to Service Codes (English, PDF 83.97 KB)
Open DOCX file, 21.22 KB,  DEN-90: Revised Regulations and Updates to Service Codes (English, DOCX 21.22 KB)
Open PDF file, 84.02 KB,  DEN-89: Corrections to Service Codes (English, PDF 84.02 KB)
Open DOCX file, 21.27 KB,  DEN-89: Corrections to Service Codes (English, DOCX 21.27 KB)
Open PDF file, 85.12 KB,  DEN-88: New Modifiers for Provider Preventable Conditions That Are National Coverage Determinations (English, PDF 85.12 KB)
Open DOCX file, 21.3 KB,  DEN-88: New Modifiers for Provider Preventable Conditions That Are National Coverage Determinations (English, DOCX 21.3 KB)
Open PDF file, 85.78 KB,  DEN-87: Addition of New Service Codes, Revised Orthodontic Form, Dental Policy Clarifications, and Reminders for Covered Services and Conditions of Payment (English, PDF 85.78 KB)
Open DOCX file, 21.35 KB,  DEN-87: Addition of New Service Codes, Revised Orthodontic Form, Dental Policy Clarifications, and Reminders for Covered Services and Conditions of Payment (English, DOCX 21.35 KB)
Open PDF file, 86.36 KB,  DEN-86: Correction to Service Code and Description for D1351 (English, PDF 86.36 KB)
Open DOCX file, 21.24 KB,  DEN-86: Correction to Service Code and Description for D1351 (English, DOCX 21.24 KB)
Open PDF file, 86.27 KB,  DEN-85: Revisions to the MassHealth Dental Program (English, PDF 86.27 KB)
Open DOCX file, 21.29 KB,  DEN-85: Revisions to the MassHealth Dental Program (English, DOCX 21.29 KB)
Open PDF file, 86.59 KB,  DEN-84: Revisions to the MassHealth Dental Program (English, PDF 86.59 KB)
Open DOCX file, 21.33 KB,  DEN-84: Revisions to the MassHealth Dental Program (English, DOCX 21.33 KB)
Open PDF file, 86.65 KB,  DEN-83: Revisions to Dental Regulations and Service Codes and Descriptions (English, PDF 86.65 KB)
Open DOCX file, 21.37 KB,  DEN-83: Revisions to Dental Regulations and Service Codes and Descriptions (English, DOCX 21.37 KB)
Open PDF file, 122.98 KB,  DEN-82: Appendix G (English, PDF 122.98 KB)
Open TXT file, 3.91 KB,  DEN-82: Appendix G (English, TXT 3.91 KB)
Open PDF file, 86.66 KB,  DEN-81: Revisions to Dental Regulations and Service Codes and Descriptions (English, PDF 86.66 KB)
Open DOCX file, 21.44 KB,  DEN-81: Revisions to Dental Regulations and Service Codes and Descriptions (English, DOCX 21.44 KB)
Open PDF file, 86.65 KB,  DEN-80: Revisions to Dental Regulations and Service Codes and Descriptions (English, PDF 86.65 KB)
Open DOCX file, 21.34 KB,  DEN-80: Revisions to Dental Regulations and Service Codes and Descriptions (English, DOCX 21.34 KB)
Open PDF file, 86.33 KB,  DEN-79: Revisions to Service Codes and Descriptions (English, PDF 86.33 KB)
Open DOCX file, 21.42 KB,  DEN-79: Revisions to Service Codes and Descriptions (English, DOCX 21.42 KB)
Open PDF file, 174.8 KB,  DEN-78: Revisions to Regulations about Medicare Part D (English, PDF 174.8 KB)
Open TXT file, 69.47 KB,  DEN-78: Revisions to Regulations about Medicare Part D (English, TXT 69.47 KB)
Open PDF file, 1.25 MB,  DEN-77: Coverage of Dental Services for Members Aged 21 Years or Older (English, PDF 1.25 MB)
Open DOCX file, 21.36 KB,  DEN-77: Coverage of Dental Services for Members Aged 21 Years or Older (English, DOCX 21.36 KB)
Open PDF file, 83.06 KB,  DEN-76: Revised Regulations About New Tobacco Cessation Services (English, PDF 83.06 KB)
Open TXT file, 18.86 KB,  DEN-76: Revised Regulations About New Tobacco Cessation Services (English, TXT 18.86 KB)
Open PDF file, 98.12 KB,  DEN-75: Revision to Regulations About Medicare Part D (English, PDF 98.12 KB)
Open TXT file, 21.57 KB,  DEN-75: Revision to Regulations About Medicare Part D (English, TXT 21.57 KB)
Open PDF file, 86.61 KB,  DEN-74: Revised Dental Regulations and Service Codes (English, PDF 86.61 KB)
Open DOCX file, 21.38 KB,  DEN-74: Revised Dental Regulations and Service Codes (English, DOCX 21.38 KB)
Open PDF file, 86.7 KB,  DEN-73: Coverage of Comprehensive Dental Benefits for Pregnant Women and for Mothers with a Child Under the Age of Three Years (English, PDF 86.7 KB)
Open DOCX file, 21.46 KB,  DEN-73: Coverage of Comprehensive Dental Benefits for Pregnant Women and for Mothers with a Child Under the Age of Three Years (English, DOCX 21.46 KB)
Open PDF file, 313.44 KB,  DEN-72: Revised Pharmacy Services Regulations (English, PDF 313.44 KB)
Open TXT file, 24.79 KB,  DEN-72: Revised Pharmacy Services Regulations (English, TXT 24.79 KB)
Open PDF file, 86.73 KB,  DEN-71: Elimination of Prior Authorization and Reduction of Limitations for Certain Service Codes (English, PDF 86.73 KB)
Open DOCX file, 21.48 KB,  DEN-71: Elimination of Prior Authorization and Reduction of Limitations for Certain Service Codes (English, DOCX 21.48 KB)
Open PDF file, 64.54 KB,  DEN-70: Revision to Service Limitations (English, PDF 64.54 KB)
Open RTF file, 4.03 MB,  DEN-70: Revision to Service Limitations (English, RTF 4.03 MB)
Open PDF file, 86.42 KB,  DEN-69: 2005 HCPCS (English, PDF 86.42 KB)
Open DOCX file, 21.41 KB,  DEN-69: 2005 HCPCS (English, DOCX 21.41 KB)
Open PDF file, 253.66 KB,  DEN-68: Revised Pharmacy Services Regulations (English, PDF 253.66 KB)
Open TXT file, 1.58 KB,  DEN-68: Revised Pharmacy Services Regulations (English, TXT 1.58 KB)
Open PDF file, 186.57 KB,  DEN-67: Revised Nonlegend Drug List (English, PDF 186.57 KB)
Open TXT file, 3.68 KB,  DEN-67: Revised Nonlegend Drug List (English, TXT 3.68 KB)
Open PDF file, 86.48 KB,  DEN-66: 2004 HCPCS (English, PDF 86.48 KB)
Open DOCX file, 21.46 KB,  DEN-66: 2004 HCPCS (English, DOCX 21.46 KB)
Open PDF file, 173.24 KB,  DEN-65: Revised Nonlegend Drug List (English, PDF 173.24 KB)
Open RTF file, 128.7 KB,  DEN-65: Revised Nonlegend Drug List (English, RTF 128.7 KB)
Open PDF file, 233.96 KB,  DEN-64: Revised Regulations about Pharmacy Services (English, PDF 233.96 KB)
Open RTF file, 239.34 KB,  DEN-64: Revised Regulations about Pharmacy Services (English, RTF 239.34 KB)
Open PDF file, 262.29 KB,  DEN-63: 2003 HCPCS (English, PDF 262.29 KB)
Open DOCX file, 21.48 KB,  DEN-63: 2003 HCPCS (English, DOCX 21.48 KB)
Open PDF file, 1.39 MB,  DEN-62: Age Limitations for Dentures and Revised Regulations and Service Codes and Descriptions (English, PDF 1.39 MB)
Open DOCX file, 21.52 KB,  DEN-62: Age Limitations for Dentures and Revised Regulations and Service Codes and Descriptions (English, DOCX 21.52 KB)
Open PDF file, 86.46 KB,  DEN-61: Dental HCPCS (English, PDF 86.46 KB)
Open DOCX file, 21.43 KB,  DEN-61: Dental HCPCS (English, DOCX 21.43 KB)
Open PDF file, 86.34 KB,  DEN-60: Revisions to Subchapter 6 Service Codes and Descriptions (English, PDF 86.34 KB)
Open DOCX file, 21.51 KB,  DEN-60: Revisions to Subchapter 6 Service Codes and Descriptions (English, DOCX 21.51 KB)
Open PDF file, 373.71 KB,  DEN-59: Revisions to the MassHealth Dental Program (English, PDF 373.71 KB)
Open RTF file, 970.37 KB,  DEN-59: Revisions to the MassHealth Dental Program (English, RTF 970.37 KB)

Help Us Improve Mass.gov  with your feedback

Please do not include personal or contact information.
Feedback