CurrentKaiser PermanentePolicy 00-00
Clinical Review General Anesthesia Dental Procedures Ga
Defines when general anesthesia and facility charges for dental procedures are covered by the Health Plan (Georgia) and the authorization and facility requirements. Dental procedure fees themselves are not covered.
Policy Summary
PayerKaiser Permanente
PolicyClinical Review General Anesthesia Dental Procedures Ga
Policy CodePolicy 00-00
Change TypeReviewed/Revised
Effective DateFeb 13, 2023
Next Review Date
Key ActionQuality Resource Management must authorize general anesthesia and facility services in advance for dental procedures.
SourceLink
POLICY UPDATE CHANGES
Document was reviewed/revised with last revision date 8/8/2024 and effective date 2/13/2023.
4Qualifying clinical indications
2Required administrative actions (PA + designated facility)
1Covered benefit types (anesthesia & facility fees only)
Coverage Summary
Defines when general anesthesia and facility charges for dental procedures are covered by the Health Plan (Georgia). Dental procedure fees are not covered. Prior authorization and facility designation requirements apply.