09 November 2022

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CMS finalizes Medicare dental services payment policies

CDA applauds move to pay for some dental exams, treatments

Mary Guiden

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In a move announced Nov. 1, the U.S. Department of Health and Human Services (HHS), through its Centers for Medicare & Medicaid Services (CMS), expanded access to dental care, behavioral health care and cancer screening coverage.

The 2023 Physician Fee Schedule final rule announced Nov. 1 also promotes innovation and coordinated care in the Medicare program through Accountable Care Organizations.

HHS Secretary Xavier Becerra said that The Biden-Harris Administration is committed to expanding access to vital prevention and treatment services. “Providing whole person support and services through Medicare will improve health and wellbeing for millions of Americans and even save lives,” he said in a news release.

Beginning in 2023, Medicare will pay for dental examinations and treatments in more circumstances, including to eliminate infection preceding an organ transplant and certain cardiac procedures.

Looking ahead to 2024, Medicare will also cover dental care prior to treatment for head and neck cancers. CMS is establishing an annual process to review public input on other circumstances when payment for dental services may be allowed.

Leaders of the Academy of General Dentistry previously said that CMS does not have the authority to expand coverage. The Academy accused CMS of trying to implement portions of a “Medicare for All” strategy, which is outside its purview.

The California Dental Association applauded the federal government's move, issuing a news release on Nov. 3 voicing support for the expansion of coverage for medically necessary dental procedures in Medicare. CDA said the move is "a critical step that will improve access, equity and outcomes for Medicare beneficiaries."

The Association’s Medicare Workgroup submitted recommendations to the federal government on how to make an expansion of dental services feasible for dentists and patients. The association posted its comments online.

Read the Sept. 13 Dentistry33 article on the proposed Medicare expansion.