Informational Bulletin 26-20

Louisiana Department of Health Informational Bulletin 26-20, issued November 2, 2026, establishes Louisiana Medicaid coverage for in-office general anesthesia administered by a Louisiana-licensed anesthesiologist, CRNA, or dental anesthesiologist during dental procedures. Coverage applies to beneficiaries enrolled in EPSDT, the Adult Waiver program, and the ICF/IID Dental Program. Provider requirements impose several conditions on the treating dentist. The dentist must hold a moderate sedation permit; for EPSDT enrollees under age 13, the dentist must hold a pediatric moderate sedation certification permit. All dental providers must comply with Louisiana State Board of Dentistry administrative rules governing third-party anesthesia in dental offices, and third-party anesthesia providers must comply with Louisiana statutes governing professional authority, supervision, and scope of practice. Third-party anesthesia providers must complete dental benefit program manager (DBPM) credentialing, enroll in Louisiana Medicaid, and demonstrate experience administering anesthesia for procedures involving the oral cavity. Coverage is limited to participating DBPM anesthesia providers. The treating dentist bears responsibility for demonstrating medical necessity and obtaining DBPM prior authorization for each case, using CDT code D9999. Coverage is capped at two services per enrollee per year, and reimbursement for third-party sedation is paid to the treating provider at the flat rate published on the Louisiana Medicaid Dental Fee Schedule.