MedicaidBilling CodesMedium impact
Attention: All Dental Providers Revisions to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Service D9248
NC Medicaid - NCDHHS·NC · Dentistry·Specialty Services
Effective date
Jan 1, 2026
We identified it
Jun 16, 2026
Summary
Effective January 1, 2026, dental procedure code D9248 (non-intravenous conscious sedation) is being deleted and replaced with D9245 (administration of moderate sedation - enteral) for NC Medicaid EPSDT services. The reimbursement rate remains the same at $127.12, but existing prior approvals for D9248 must be updated to D9245 for services rendered on or after the effective date.
Action Required
Before January 1, 2026: Billing team must update billing system to replace code D9248 with D9245 for moderate sedation services. For existing prior approvals granted for D9248, contact NCTracks Customer Service at 800-688-6696 to request a 'Dental Prior Approval Ticket' to update the code to D9245 if service date is on or after Jan 1, 2026. Update encounter forms and billing software rules to ensure proper code usage based on service dates.