Early association of expanded Medicare dental benefits to dentist billing in Medicare

Abstract

Background: Although Medicare is barred from covering most oral health care, policies enacted by the Centers for Medicare & Medicaid Services have expanded coverage of dental procedures for Medicare beneficiaries receiving certain medical treatments and made it easier for dentists to submit claims electronically.

Methods: The authors extracted monthly counts of the number of Medicare-billing dentists from the Centers for Medicare & Medicaid Services "Doctors and Clinicians" files from January 2021 through December 2024. Considering the implementation dates of the reforms, we estimated a single-group interrupted time-series analysis separately for all dentists, oral surgeon dentists, and non-oral surgeon dentists to measure any association of the reforms with dental care provider participation in Medicare.

Results: After the Medicare dental benefit expansions, the preexisting downward trend in the number of Medicare-billing oral surgeons continued, although the transition to electronic claim forms appeared to be associated with a reverse in this decline. Among non-oral surgeon dentists, after the first dental benefit expansion, the monthly increase in the number of billing dental care providers accelerated 0.8% (95% CI, 0.47% to 1.12%).

Conclusions: Despite new opportunities for Medicare beneficiaries to access oral health care, there have not been marked increases in the number of dentists billing Medicare, a trend largely associated with oral surgeons. Dentists may remain hesitant to participate in Medicare or are unaware of the new policies.

Practical implications: The authors lacked access to claims volume or patient outcome data and these elements will be needed in future research to further assess the association of Medicare dental reforms on patients.

Keywords: Medicare dental benefits; Medicare dentist participation; interrupted time-series analysis.