Consortium for Medically Necessary Oral Health Coverage Issues Statement on Medicare Coverage

In a public statement released today, the Consortium for Medically Necessary Oral Health Coverage commended the Biden Administration for finalizing regulatory policy that will have a direct and meaningful impact in the lives of many Medicare beneficiaries. With today’s action, the Medicare program is taking an important step towards much-needed coverage of medically necessary oral and dental care. 

Specifically, the final Physician Fee Schedule for 2023 codifies Medicare coverage for dental services that are inextricably linked and substantially related and integral to organ transplant surgery, cardiac valve replacement, valvuloplasty procedures, and head and neck cancers. The final rule also creates the opportunity for further coverage expansion by establishing “a process to identify for [the Medicare program’s] consideration and review submissions of additional dental services that are inextricably linked and substantially related and integral to the clinical success of other covered medical services.” Finally, the rule codifies Medicare coverage for the wiring of teeth related to covered medical services, the reduction of jaw fractures, the extraction of teeth in preparation for radiation treatment of neoplastic disease, dental splints for covered treatment of certain medical conditions, and oral or dental examinations relating to renal transplant surgery. 

“This regulatory action is the start of a new era for integrated health in America,” said Dr. Michael Alfano, D.M.D., Ph.D., cofounder of the Santa Fe Group and the Consortium. “On behalf of the hundreds of organizations who have worked for this policy change, we thank the Administration for expanding access to Medicare-covered medically necessary oral and dental treatment.” 

Click here to download a copy of the Consortium’s full statement.


Comments (1)

  • Congratulations on this outstanding achievement and thank you for the years of work spent to move forward on medical/dental integration! As a dental hygienist, I’ve known for years that the mouth was a portal for disease-carrying bacteria which exacerbate other chronic systemic diseases. Let’s start upstream by utilizing the prevention models, saving costs downstream. My goal is to see that each individual receives at least two prophylactic cleanings and assessments per year as part of a complete physical medical exam. 🙂 If there is any way I can help, please contact me.

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