Hospital Billing for Dental Procedures Performed in the Outpatient Setting
The MO HealthNet Division (MHD) reimburses MO HealthNet-enrolled hospitals for dental procedures performed in their facilities. Providers should bill using the Current Dental Terminology© (CDT) codes included on the MHD Fee Schedule under Outpatient Hospital to receive maximum reimbursement for services.
Procedure code 41899 (UNLISTED PX DENTALVLR STRUX) should only be billed when there is no specific CDT code available for the dental procedure performed in the hospital.
Example: Anesthesia services should not be billed to code 41899, but instead should be billed utilizing the appropriate CDT code:
D9222- DEEP ANEST, 1ST 15 MIN
D9223- GENERAL ANESTH EA ADDL 15 MI
Providers should contact MHD.ClinicalServices@dss.mo.gov if a CDT code for a procedure is not found on the MHD Fee Schedule. Please refer to the Outpatient Simplified Fee Schedule FAQs for more information about this payment method.
This information also applies to providers contracted with MHD’s Managed Care Organizations.
Please join us on May 15, 2024, for a training specifically for hospital providers covering how to bill for dental procedures. This is a one hour training beginning at 10:00 am. Register online for the Hospital Billing for Dental Procedures Performed in the Outpatient Setting.
Review Navigating Provider Resources or register for an upcoming provider training for more information on MHD Fee Schedules.