KMAP BULLETIN: New Provider Specialty for Sedation Dental

Date: 10/23/24

Effective with enrollment dates on or after November 1, 2024, Dental providers with the appropriate license/permit or who contract with a provider that is licensed and within their scope of practice to provide sedation services will have the option to choose the specialty type ‘Sedation Dental.’ To add the new specialty, sedation services must be medically necessary and must be available to members during dental services.

The Provider Type/Provider Specialty (PT/PS) will be 27/269 (Dentist/Sedation Dental). Dental providers offering sedation services may add this specialty to their current enrollment using the taxonomy code 1223D0004X.

Billing Guidelines

The contracted provider must continue to bill for their services under their current PT/PS. This new PT/PS 27/269 will not have billing purposes

Note: The effective date of the policy is November 1, 2024. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.

For the changes resulting from this provider bulletin, view the updated Dental Fee-for-Service Provider Manual, Introduction, pages i-2 and i-3.