In partnership with the American Academy of Pediatric Dentistry (AAPD), and the American Association of Oral and Maxillofacial Surgeons (AAOMS), ADA worked with CMS to establish the G0330, which is a billing code for the facility fee to be used with HOPPS & ASC Payment Schedules under Medicare.
ADA anticipates that hospitals will ask dentists for guidance on billing, and this toolkit can be shared with hospital administration to explain these increased facility fees. The toolkit also includes a sample advocacy letter to State Medicaid Agencies (SMAs) to advocate for the use of this code with Medicaid/CHIP.
View G0330 billing codes (ZIP)
The zip file contains qualifying billing codes to use for facility fees depending whether the procedures occur in hospital (HOPPS) or ambulatory surgical centers (ASC). However, if there are not applicable procedures or codes listed in each setting, then G0330 can be used in the hospital-based setting along with auxiliary codes for ASCs.
G0330 is a code that can be adopted through Medicaid programs on the state level, and the accompanying reimbursement schedules can help guide states' reimbursement for hospital-based dental procedures.
Establishing this billing code and reimbursements for certain procedures can greatly help dentists advocate for operating room time for dental procedures in local hospitals or ambulatory surgical centers.