All PlansCoverageMedium impact
Coverage for Ambulatory Surgery Unit (ASU) and Anesthesia for Dental Services 7.03.01
Excellus BlueCross BlueShield·Dentistry, Anesthesiology, Oral & Maxillofacial Surgery +1 more·Anesthesiology
Effective date
May 21, 2026
We identified it
Jun 20, 2026
Summary
New policy establishes coverage criteria for ambulatory surgery unit facilities and anesthesia services for dental procedures under medical plans. Coverage is approved for children 7 and under, patients with developmental disabilities, concurrent medical conditions, or behavioral management issues with documented failed office attempts.
Action Required
Before May 21, 2026: Update billing system to recognize new coverage criteria for ASU dental services under medical plans. Ensure documentation requirements are met including treatment plans, health history, and failed office attempt records for behavioral/developmental cases. Verify anesthesiologist credentials for anesthesia billing. Train staff on medical necessity criteria for ages 7 and under, developmental disabilities, medical conditions, and behavioral issues.