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Anesthesia Services Procedure Code G0330 to Become a Benefit of Texas Medicaid Effective September 1, 2024

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This article has been updated. To view the updated information, see Correction to “Anesthesia Services Procedure Code G0330 to Become a Benefit of Texas Medicaid Effective September 1, 2024” | TMHP.

 

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Effective for dates of service on or after September 1, 2024, procedure code G0330 for facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation and the use of an operating room) will become a benefit of Texas Medicaid.

Procedure code G0330 may be reimbursed for facility services as follows:

  • To hospital providers for medical services rendered in the outpatient hospital setting
  • To ASC and HASC providers for ASC services rendered in the outpatient hospital setting
  • For dental rehabilitation procedures performed on a client who requires monitored anesthesia care (e.g., general, intravenous sedation and the use of an operating room)

Procedure code G0330 should be billed in lieu of procedure code 41889 submitted with modifier U3. Procedure code 41889 submitted with modifier U3 will no longer be a benefit of Texas Medicaid.

For more information, call the TMHP Contact Center at 800-925-9126.