Dental Services
This page is a central location for dental information, including CMS resources.
Spotlight
- Medicare Dental Coverage
- Using the KX Modifier for Dental Services Inextricably Linked to Covered Medical Services
Enrolling
The following resources support enrollment activities for dental:
Policy Information
Not all services have a policy associated with them. We will consider Reasonable and Necessary Guidelines in the absence of a LCD, billing and coding article, NCD, or CMS manual instruction that limits coverage.
LCDs
Learn more about the LCD development process through the following:
Search for dental-related LCDs using these available resources:
- LCD Interactive Index Tool
- View First Coast's active / proposed LCDs on CMS Medicare Coverage Database (MCD)
NCDs
Search for dental-related NCDs using these available tools:
Medical Documentation
For a claim to be valid, documentation must demonstrate compliance with all applicable coverage, coding and billing requirements and substantiate the level of care billed. The following resources are specific to dental, but may not address all required medical documentation requirements:
Claim Submission and Reimbursement
Additional Information
- View our FastTrack to Medicare Coverage Policies Tool to locate guidelines
CMS
- CMS IOM Pub. 100-01 Medicare General Information, Eligibility, and Entitlement, Chapter 4, Sections 10.3 and 70
- CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 1, Section 30 and 70
- CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15, Section 60, 120C and 150
- CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 16, Section 140
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CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 25 and Chapter 26
- CMS IOM Pub. 100-08 Medicare Program Integrity Manual, Chapter 3, Section 3.6.2.2
- CMS Oral Health Engagement
- Change Request (CR) 13181, Medicare Policy Updates for Dental Services as Finalized in the Calendar Year (CY) 2023 Physician Fee Schedule (MPFS) Final Rule
- CR 13190, Educational Instructions for the Implementation of the Medicare Payment Provisions for Dental Services as Finalized in the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) Final Rule
Education
View our wide selection of free, live and on-demand training options.
- View our upcoming Educational Events Calendar
- View On-demand Learning
Stay Informed
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