The Centers for Medicare & Medicaid Services published its inaugural fact sheet listing the progress of its oral health cross-cutting initiative.
CMS updated its strategic plan to include an oral health initiative in May 2023. The strategic plan includes 13 cross-cutting initiatives focused on advancing equity, expanding access, engaging partners, driving innovation, protecting programs and fostering excellence.
Here are six notes from the fact sheet:
1. CMS highlighted its efforts to strengthen Medicare oral health coverage through final rules in its physician fee schedules for 2023 and 2024. CMS authorized Medicare to pay for dental
services that are inextricably linked and integral to the clinical success of a specific treatment of an individual’s primary medical condition. It also finalized Medicare payment rates under the hospital outpatient prospective payment system for more than 240 dental codes.
2. The organization pointed to several advancements in Medicaid dental coverage, including added coverage for pregnant or postpartum enrollees.
3. CMS supported an initiative to advance oral health prevention in primary care and finalized quality measures for Medicaid and CHIP programs, which includes measures related to oral exams, fluoride application and dental sealants for children.
4. CMS finalized two policies in its 2024 payment notice related to stand-alone dental payments.
5. CMS added a policy in its 2025 payment notice that allows states to update their benchmark plans to include routine adult dental services as essential health benefits.
6. CMS expanded its collection efforts for oral health data as it relates to Medicare enrollees through the Medicare Current Beneficiary Survey. This expansion includes data collection for overall oral health, tooth sensitivity and dry mouth symptoms.