Last week the Centers for Medicare & Medicaid Services (CMS) released the 2023 Medicare Physician Fee Schedule (PFS) proposed rule, with publication in the Federal Register expected on July 29, 2022. It includes a proposal to broaden reimbursement for medically necessary dental services and seeks comments on various circumstances in which coverage would be appropriate. The Center for Medicare Advocacy will provide summaries of the proposed rule, template comments and additional information in the weeks ahead. Comments are due to the CMS by Sept. 6, 2022.
- Proposed Rule: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched
- Dental portion of proposed rule (pages 433-457) https://medicareadvocacy.org/wp-content/uploads/2022/07/CMS-PFS-Proposed-Rule-for-2023_Dental-Coverage_pages-433-457.pdf
- Center for Medicare Advocacy, Families USA, Justice in Aging, Medicare Rights Center, Henry Schein Cares Foundation, and CareQuest Institute for Oral Health joint fact sheet on “medically necessary” dental: https://medicareadvocacy.org/wp-content/uploads/2022/07/OH-2022-94_Medicare-Medically-Necessary-Fact-Sheet-1-1.pdf
- Medicare Oral Health Coalition (of which the Center for Medicare Advocacy is a member) statement on the proposed rule: https://medicareadvocacy.org/wp-content/uploads/2022/07/MOHC-Statement_medically-necessary-2023-PFS_final.pdf
July 14, 2022 – K. Kertesz