New York Codes, Rules and Regulations
Chapter II - Regulations of the Department of Social Services
Subchapter E - Medical Care
Article 4 - Fees and Reimbursement
Part 535 - State Reimbursement For Payment To Dentists
Section 535.4 - Anesthesia

Current through Register Vol. 45, No. 13, March 29, 2023

(a) Anesthesia services for in-hospital oral surgery.

(1) Expenditures by social services districts for anesthesia services for in-hospital oral surgery shall be reimbursable:
(i) if the anesthetic is administered personally by a qualified dentist or physician who remains in constant attendance during the procedure for the sole purpose of rendering such anesthesia service; and

(ii) if the Commissioner of Health or his designee determine such care, services and supplies are coverable benefits under the provisions of Part 505 of this Subchapter.

(2) The maximum reimbursable allowance for anesthesia services for in-hospital oral surgery shall be calculated by adding $5 for each 15 minutes of anesthesia time (T) plus 80 per cent of the basic fee established in conjunction with the appropriate oral surgery procedure set forth in section 535.5.

(3) Total values for anesthesia services for in-hospital oral surgery shall include preoperative and postoperative visits, the administration of the anesthetic and the administration of fluids and/or blood incident to the anesthesia or surgery.

(b) Anesthesia services for office procedures.

(1) The maximum reimbursable allowance for local anesthesia rendered in a dentist's office shall be included in the fees established for the individual procedures.

(2) General anesthesia for in-office procedures may be administered by a qualified person other than the operating dentist and is reimbursable according to the provisions therefor in section 535.5.

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