CMS has added an oral health incentive as part of its merit-based payment system, according to its 2026 Medicare Physician Fee Schedule. Three notes: 1. The merit-based incentive payment system adjusts Medicare reimbursements based on providers’ performance, rewarding them for…
Revenue Cycle Management
Low Medicaid reimbursements are putting dentists in a tight financial position, placing many providers at a crossroads that could deepen the country’s dental care accessibility challenges. Only 12 states have a reimbursement rate of 80% or more for children Medicaid…
Medicaid recipients in rural Missouri are still struggling to access dental care despite the state expanding Medicaid coverage, Kansas City Mag reported Oct. 26. Five notes: 1. Missouri expanded Medicaid dental benefits over the summer, allowing adults to receive routine…
An Alabama dentist’s struggle with Medicaid reimbursements highlights an ongoing challenge among clinicians in the industry, Stateline reported Oct. 23. Six notes: 1. Carson Cruise, DMD, is the owner of Pediatric Dentistry of Florence, and the only board-certified pediatric dentist…
Here are 10 updates pointing to shifts in how dentists are interacting with insurers and how the industry is holding payers more accountable: 1. Eighteen states have passed a total of 37 dental insurance reform laws so far this year,…
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Eighteen states have passed a total of 37 dental insurance reform laws so far this year, according to the American Dental Association. Seven notes: 1. The most common insurance issues addressed this year include dental loss ratios, virtual credit cards,…
From lawsuits to payer challenges, here are six dental RCM updates since September: 1. The American Dental Association is supporting dentists dealing with claim downcoding by third-party insurers. 2. About 25% of dentists have dropped out of insurance networks so…
The American Dental Association is supporting dentists dealing with claim downcoding by third-party insurers. Five notes: 1. The ADA said Oct. 7 that it will support states and dental providers addressing downcoding in response to increased reports of the practice.…
About 25% of dentists have dropped out of insurance networks so far this year, according to the American Dental Association’s “Economic Outlook and Emerging Issues in Dentistry” report for the third quarter of 2025. The ADA’s Health Policy Institute surveyed…
California Gov. Gavin Newsom signed SB 386 into law, which requires dental plans to provide dentists with clear and easy ways for dentists to opt in and out of virtual credit card payments, according to an Oct. 3 news release…