Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
SC Medicaid - SCDHHSMedicaid · Coverage · Specialty Services · SC · Dentistry, Oral & Maxillofacial SurgeryMedium impact

Dental Services Policy Updates

Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 18, 2026

Summary

South Carolina Medicaid is adding coverage for new dental sedation and anesthesia codes (D9224, D9225, D9244, D9245, D9246, D9247) and orthodontic codes (D8091, D8671) effective January 1, 2026. Coverage varies by patient age and special needs status, with different reimbursement rates for children versus adults.

Get alerts when payers change rules like this one

We check SC Medicaid - SCDHHS and other payers every day and email you when a change matches your specialty and state.

Get SC Medicaid - SCDHHS alertsPolicy Monitoring is free. No card required.

What to do

by Jan 1, 2026 · 5 steps
01Billing team must add new dental CDT codes D9224, D9225, D9244, D9245, D9246, D9247, D8091, and D8671 to billing system with age-based rate differentials.
02Configure system to prevent billing conflicting sedation codes together on same day.
03Set up prior authorization requirements for D8091 and D8671.
04Update fee schedules with different rates for children/ID-RD waiver patients versus adults.
05Ensure providers verify patient eligibility and sedation permit requirements before billing.

Codes mentioned

D9224D9225D9244D9245D9246D9247D8091D8671

Original notice

Dental Services Policy Updates
scdhhs.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

SC Medicaid - SCDHHS policiesSC policy changesDentistryOral & Maxillofacial SurgeryCode D9224Code D9225Code D9244Code D9245Code D9246Code D9247Code D8091Code D8671

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account