Medicare Billing For Dentists

Generally, original Medicare does not cover routine dental items and services connected with the care, treatment, removal, filling, or replacement of teeth, dental devices such as dentures or plates, or structures directly supporting the teeth.

Medicare will pay for:

Dental services that are an integral part of a covered service

Extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances.

You can also check various online sources to know more about medicare billing system.

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If specific requirements are met, certain dental items and services, such as dental sleep apnea devices, may be covered in certain geographic areas through local coverage determinations

Whether services as the administration of anesthesia, diagnostic x-rays, and other related procedures are covered depends upon whether the primary procedure being performed by the dentist is itself covered.

Medicare Advantage plans are private health insurance plans that offer some dental benefits and may cover routine preventive care, such as cleanings, X-rays, and regular exams, either partially or in full, and also provide some coverage for extractions, root canals, dentures, crowns, fillings, and treatment for gum disease.

Know When to Enrol in Medicare: Dentists who provide Medicare Part B covered items and services need to either enrol in Medicare or formally opt out.

Even if they don’t provide Medicare Part B covered items and services, they need to either enrol or formally opt out if they order covered clinical laboratory services, imaging services, or DMEPOS for patients who are on Medicare.

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