Santa Fe Group Submits Dental and Oral Health Recommendations to CMS for CY 2027
On February 10, 2026, the Santa Fe Group submitted formal recommendations to the Centers for Medicare & Medicaid Services (CMS), outlining evidence-based recommendations for expanding Medicare coverage of medically necessary dental and oral health services for Contract Year 2027. The letter responds to CMS’s annual Physician Fee Schedule (PFS) nominations process and builds on recent federal policy advancements that recognize the critical role oral health plays in overall health outcomes for older adults and medically complex populations.
In this nomination, SFG highlights key clinical situations in which dental services are integral to the success of covered medical procedures and should be clearly recognized for Medicare payment. Among these are:
- Prevention of hospital-acquired pneumonia (HAP): Evidence shows that timely dental assessments and preventive care reduce respiratory complications and improve surgical outcomes.
- Oral health in complex chronic conditions: Periodontal treatment and other dental services are strongly linked to the effective medical management of conditions such as diabetes-associated retinopathy and nephropathy, where oral inflammation can impact broader health outcomes.
The letter acknowledges progress CMS has made in recent rulemaking — including steps toward integrating oral health into Medicare quality programs and clarifying coverage pathways for medically necessary oral health services — while urging continued advancement of policy that aligns clinical evidence, payment policy, and health equity principles.
Click here to read the full document:
SFG Dental & Oral Health Recommendations for CY 2027 (PDF)
