From advancing legislation to new modifier codes, here are 10 updates to know impacting dental Medicaid and Medicare that Becker’s reported on in the first quarter of 2025:
- The orthodontic scoring tool within the Illinois Medicaid program updated its rules and scoring criteria.
2. The Arizona Senate passed a bill to expand the state’s adult Medicaid coverage to include comprehensive dental benefits.
3. A coalition of more than 70 organizations wrote a letter urging congressional leaders to protect the Medicaid program.
4. Sen. Bernie Sanders and Rep. Lloyd Doggett introduced bicameral legislation to expand access to dental, hearing and vision care under Medicare.
5. Dental practices could see significant revenue losses if Medicaid funding is cut, according to a report from the Urban Institute and Robert Wood Johnson Foundation.
6. A bill proposed in the Florida Senate would expand dental services for Medicaid recipients and raise reimbursement rates for dentists.
7. Lawmakers in North Carolina are pushing to increase Medicaid reimbursement rates for dentists.
8. Alabama dentists asked legislators to provide emergency funding as they lose money on Medicaid services.
9. The American Dental Association urged CMS to strengthen dental Medicare Advantage protections, including increased oversight of supplemental dental benefits.
10. Starting July 1, dentists enrolled in Medicare will need to add an administrative modifier code to each procedure code on the ADA dental claim form.
Source: The top dental Medicaid, Medicare updates to know from Q1 / Becker’s Dental + DSO Review