MedicaidBilling CodesHigh impact
Attention: All Dental Providers: Revisions to Anesthesia and Sedation Services
NC Medicaid - NCDHHS·NC · Dentistry, Oral & Maxillofacial Surgery, Anesthesiology·Specialty Services
Effective date
Jan 1, 2026
We identified it
Jun 16, 2026
Summary
NC Medicaid has revised dental anesthesia and sedation billing codes effective January 1, 2026, implementing new billing restrictions that prevent nitrous oxide (D9230) from being billed on the same date of service as other anesthesia/sedation codes (D9222, D9223, D9239, D9243). The revisions clarify that deep sedation and moderate sedation codes now include co-administration of nitrous oxide.
Action Required
Before January 1, 2026: Billing team must update dental billing system to prevent billing D9230 (nitrous oxide) on the same date of service as D9222, D9223, D9239, or D9243. Update encounter forms and provider documentation to reflect that nitrous oxide administration is included in deep sedation and moderate sedation codes. Configure system edits to block these combinations as claims will be automatically denied by NC Medicaid.