Updates for Dental Services Rendered in an Ambulatory Surgical Center

The South Carolina Department of Health and Human Services (SCDHHS) issued Medicaid billing bulletin MB# 26-043, effective December 1, 2026, updating reimbursement and billing guidelines for dental services rendered in ASCs under the South Carolina Healthy Connections Medicaid program. ASC providers must use procedure code G0330 to bill for operating room-related facility services when dental rehabilitation is performed under anesthesia. Only one unit of G0330 is allowed per date of service, per patient, regardless of the number of dental procedures performed or the duration of the dental event. The facility rate for G0330 is set at $1,359. Professional services billed by physicians or dentists, including dental procedures, pre-operative and post-operative services, and anesthesia administration, are not billable by the ASC. Those services are paid separately, at the applicable rate, to the participating South Carolina Healthy Connections Medicaid provider who rendered them. Prior authorization is not required of ASC providers for dental services delivered in their facility. However, ASC claims must be submitted with a copy of the prior authorization that SCDHHS's dental administrative services organization issued to the dental provider; claims submitted without that documentation will be rejected. The updated guidelines are to be incorporated into the Clinic Services Manual and the Ambulatory Surgery Fee Schedule on December 1, 2026.