The Michigan Department of Health and Human Services (MDHHS) issued a final policy to increase Medicaid payment rates for dental services provided to patients under general anesthesia in ambulatory surgical centers (ASCs) and outpatient hospitals, effective Oct. 1, 2022.
MDHHS implemented this policy change to improve access to vital dental services for Michigan’s most vulnerable population. Due to severity of a case or special needs for children and adults with developmental or intellectual disabilities, some procedures cannot be completed in a clinic or office-based setting. The payment rate increased from $82.16 to $1,495 for ASCs and from $216.07 to $2,300 for outpatient hospitals.
The policy also modified the payment methodology for these settings, converting payment for current procedural terminology code 41899 from the Outpatient Prospective Payment System to a fee schedule based system.
Members with questions about this policy change should contact Jason Jorkasky at the MHA .