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SC Medicaid - SCDHHSMedicaid · Billing Codes · Specialty Services · SC · Dentistry, Oral & Maxillofacial SurgeryHigh impact

Updates for Dental Services Rendered in an Ambulatory Surgical Center

Act
by Dec 1, 2026
Effective date
Dec 1, 2026
Identified
Oct 30, 2026

Summary

South Carolina DHHS is updating reimbursement and billing guidelines for dental services rendered in ambulatory surgical centers (ASCs), effective December 1, 2026. ASC providers must use procedure code G0330 for operating room–related facility services during dental rehabilitation under anesthesia, with a limit of one billing per patient per date of service at a rate of $1,359. ASCs must submit claims with a copy of the approved authorization issued to the dental provider by SCDHHS' dental administrative services organization, or claims will be rejected.

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What to do

by Dec 1, 2026 · 6 steps
01Billing team must implement the following changes for ASC dental services billed to South Carolina Healthy Connections Medicaid.
02Update billing software to require use of procedure code G0330 for operating room–related facility services when billing dental rehabilitation performed under anesthesia.
03Configure billing system to enforce the limit of one G0330 billing per patient per date of service, regardless of services performed or time spent.
04Establish a process to obtain and attach a copy of the approved authorization issued to the dental provider by SCDHHS' dental administrative services organization to all claims submitted.
05Configure claims validation to reject any G0330 claims submitted without this supporting authorization documentation.
06Providers should direct implementation questions to the SC Provider Service Center at (888) 289-0709 (Monday-Thursday 7:30 a.m.–5 p.m., Friday 8:30 a.m.–5 p.m. UTC) or submit an online inquiry at https://www.scdhhs.gov/providers/contact-provider-representative.

Codes mentioned

G0330

Original notice

Updates for Dental Services Rendered in an Ambulatory Surgical Center
scdhhs.gov · Always check the source before changing claims.
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Related policy hubs

SC Medicaid - SCDHHS policiesSC policy changesDentistryOral & Maxillofacial SurgeryCode G0330

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