KMAP BULLETIN: Dental Procedure Code Update

Date: 08/21/23

KMAP GENERAL BULLETIN 23218 (PDF)

Effective with dates of service on and after September 1, 2023, code G0330 will be covered when dental procedures that are performed in an Operation Room (OR) or an Ambulatory Surgical Center (ASC) under monitored anesthesia for the facility rate. Medical Review for ages 0 to 20 and Prior Authorization (PA) for ages 21 and older will still be required. The Medicaid rate will be set to $1,722.43 in alignment with the Medicare rate.

Clarification for code 41899:
The Current Procedural Terminology (CPT) code 41899 will be covered for dental procedures not otherwise described by existing dental procedure codes. Medical review for ages 0 to 20 and PA for ages 21 and older will still be required. The Medicaid rate will be set to $207.83 in alignment with the Medicare rate.

Note: The rates noted in this bulletin are subject to future changes. Providers should check the Kansas Medical Assistance Program (KMAP) website for the most up-to-date rates.

Note: The effective date of the policy is September 1, 2023. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the KMAP bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.