Effective March 1, 2023, through June 30, 2023, NC Medicaid is implementing a temporary rate increase of 40% for dental procedure code D9230 (Inhalation of nitrous oxide/analgesia, anxiolysis).
Nitrous oxide is used by dental offices in the treatment of patients who are anxious about dental care. These patients can benefit from an anxiolytic-like nitrous oxide which has been proven to have therapeutic value in many studies. A shortage of ammonium nitrate, the key component in the production of nitrous oxide, has resulted in increased costs of nitrous oxide for dental providers.
The Department of Health and Human Services approved this temporary rate increase to support continued access to dental care for Medicaid and NC Health Choice beneficiaries in North Carolina.
| Dental Code | Pricing Specialty | Current Rate Effective Jan. 1, 2022 |
Temporary Rate Increase Effective March 1, 2023, through June 30, 2023 |
|---|---|---|---|
| D9230 | 066 – General Dentist | 44.94 | 62.92 |
| D9230 | 010 – Federally Qualified Health Centers | 45.85 | 64.19 |
| D9230 | 075 – Rural Health Centers | 45.85 | 64.19 |
| D9230 | 060 – Local Health Departments | 47.27 | 66.18 |
Providers are reminded to bill their usual and customary charges rather than the Medicaid rate. If the usual and customary charges are less than the Medicaid rate, providers will be reimbursed the lesser rate and the temporary rate increase would not apply.
For coverage criteria and additional billing guidelines, refer to Clinical Coverage Policy 4A, Dental Services, on the NC Medicaid Program Specific Clinical Coverage webpage.