CMS has expanded the dental services it will pay for as part of its finalized 2023 Physician Fee Schedule released Nov. 1.
Medicare Part B currently pays for a limited range of dental services required when the service is an essential part of a patient's primary medical condition treatment.
Three things to know about CMS' final ruling on dental services:
1. CMS finalized its proposal to clarify and codify parts of the current Medicare fee-for-services payment policies for dental services that are essential to a patient's primary medical condition treatment and other clinical scenarios where Medicare Part A and Part B payment can be made. This includes dental exams and necessary treatments before or during, organ transplants, cardiac valve replacements and valvuloplasty procedures.
2. CMS is finalizing payment for dental exams and essential treatments before treating head and neck cancers beginning in 2024. It is finalizing a process in 2023 to review and consider public recommendations for Medicare payment for dental service in similar clinical scenarios.
3. CMS is working to address feedback and questions about the operational aspects of billing and claims processing for these services.