How CMS' proposed dental care expansion could shake up the industry

CMS is proposing to expand what dental services are considered medically necessary for Medicare coverage as part of its proposed Calendar Year 2023 Physician Fee Schedule, Bloomberg Law reported Aug. 17.

If the proposal is finalized, dental care needed to treat Medicare-covered ailments, injuries and chronic diseases would be eligible for reimbursement, the news outlet reported.

Here are four ways broader Medicare dental coverage could affect the industry, according to Bloomberg Law:

  • Medicare could save $63.5 billion over 10 years by covering gum disease treatments for heart disease, stroke and diabetes patients, according to a 2016 study by Avalere Health.
  • The proposal would amend federal regulations to allow payment under Medicare hospital and outpatient coverage for dental services linked to the success of an otherwise covered medical service.
  • It could improve health equity for minority, rural and low-income patients.
  • It would clarify and expand what is considered a medically necessary service.

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