Dental industry leaders and clinicians continue to advocate for enhancements in insurance plans as they deal with stagnant reimbursements, legislative changes and potentially restrictive policies.
Five updates:
1. The American Dental Association urged UnitedHealthcare to accept dentists’ credentialing information from the CAQH Provider Data Portal instead of requiring them to submit a payer-specific application through its proprietary portal.
2. The ADA and the Academy of General Dentistry have opposed two new payment policies from Delta Delta of California and Aetna, and have asked the National Association of Insurance Commissioners and the National Council of Insurance Legislators to evaluate whether the policies are consistent with state laws and fair claims payment standards.
3. Dental payer reimbursement rates are lagging behind inflation, according to the ADA’s “State of the U.S. Dental Economy” report for the second quarter of 2026. According to the report, the reimbursement rate index, averaged across all payer types, has increased by 19% since January 2021. Inflation, however, was 27% over the same time period. When looking at the first six months of this year specifically, the reimbursement rate index increased by 1.1%, while inflation was at 1.8%.
4. Although economic confidence is trending upward for dentists, low reimbursement rates and other insurance challenges remain a cause for concern in the field, according to the same ADA report.
5. A two-paragraph provision in North Carolina’s new state budget has left oral health advocates uncertain about its implications for Medicaid coverage of dental procedures performed at ASCs. The budget, signed into law July 7, includes two paragraphs that appear to sunset modifications to the Medicaid program, including billing codes for ASC dental services on July 1. Advocates said they cannot determine the intent of the provision or its practical effect.
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