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24-108m Find Out What Changed: Sedation and Anesthesia Coverage for Dental Services

Health Net·CA · Anesthesiology, Dentistry, Oral & Maxillofacial Surgery·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health (Medi-Cal) now requires prior authorization for IV moderate sedation (D9239/D9243) and deep sedation/general anesthesia (D9222/D9223) services provided by physicians during dental procedures. The anesthesia provider must submit authorization requests and receive approval before delivering these services.

Action Required

Action needed
Immediately: Anesthesia providers must obtain prior authorization before delivering IV moderate sedation or deep sedation/general anesthesia for dental procedures. Submit Request for Authorization (RA)/Prior Authorization (PA)/Treatment Authorization Request (TAR) with complete history, physical examination, and medical necessity documentation. Update billing system to flag these dental codes for prior auth requirement. Claims without prior authorization will be subject to additional review and potential denial.

Affected Billing Codes

D9239
D9243
D9222
D9223
24-108m Find Out What Changed: Sedation and Anesthesia Coverage for Dental Services | Health Net | PolicyChanges.app