MedicaidAdministrativeMedium impact
Statewide Medicaid Managed Care: Non-Emergency Dental Services in Ambulatory Surgical Center and Outpatient Hospital Settings Effective October 1, 2025
Florida Medicaid·FL · Dentistry, Anesthesiology, Oral & Maxillofacial Surgery·Managed Care
Effective date
Oct 1, 2025
We identified it
Jun 16, 2026
Summary
Effective October 1, 2025, payment responsibility for non-emergency dental outpatient anesthesiology and sedation services performed in hospitals or ASCs will transfer from Florida Medicaid dental plans to Medicaid health plans. This change is designed to reduce administrative complexity and simplify billing for providers.
Action Required
By October 1, 2025: Billing team must update systems to submit claims for non-emergency dental outpatient anesthesiology and sedation services (when performed in hospital or ASC settings) to Medicaid health plans instead of dental plans. Update billing workflows and train staff on new submission requirements. Ensure continuity of care provisions are followed for any appointments scheduled prior to October 1st.