By JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA
October 25, 2023

ADHA recently submitted comments to The Honorable Chiquita Brooks-LaSure, Administrator for the Centers for Medicare and Medicaid Services (CMS), offering comments to CMS on the proposals and request for information on Medicare Parts A and B Payment for Dental Services in the CY 2023 Physician Fee Schedule Proposed Rule.

ADHA applauded the exemplary team at CMS and the many Members of Congress who actively urged CMS to further improve patient access to needed care by clarifying the Medicare program’s payment of medically necessary oral and dental services including cancer treatment services.

Specifically, the draft Physician Fee Schedule for 2024 proposed payment clarification for:

• Dental and oral examinations performed as part of a comprehensive workup for Medicare beneficiaries with cancer prior to the administration of chemotherapy, chimeric antigen receptor (CAR) T-cell therapy, and high-dose bone-modifying agents (antiresorptive therapy).
• Dental and oral examinations performed as part of a comprehensive workup for Medicare beneficiaries with cancer prior to the administration of radiation therapy.
• Diagnostic and treatment services (which may include imaging, anesthesia, operating room use, and other ancillary services) to eliminate oral or dental infection prior to or concurrent with the administration of radiation therapy for the duration of cancer-related immunosuppression.
• Diagnostic and treatment services (which may include imaging, anesthesia, operating room use, and other ancillary services) to eliminate oral or dental infection prior to or concurrent with the administration of chemotherapy, CAR T-cell therapy, and high-dose bone-modifying agents and for the duration of cancer-related immunosuppression.
• Dental and oral examinations as well as diagnostic and treatment services for beneficiaries receiving Medicare-covered treatment for head and neck cancer, whether primary or metastatic, regardless of site of origin, and regardless of initial modality of treatment.

ADHA joined with other leading organizations in the oral health community in urging CMS to do everything possible to educate providers about Medicare’s updated payment policy, address concerns and uncertainties, and encourage dentists to enroll in Medicare.

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JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA, is the ADHA Director of Education, Research & Advocacy, professor emerita in the Department of Dental Hygiene at ISU, and former president of the American Dental Hygienists’ Association 1990-1991.