Medicare Includes New Dental Billing Codes for 2024

For 2024 the Centers for Medicare and Medicaid Services (CMS) included new billing codes for dental surgical procedures in outpatient hospitals.

As part of its 2023 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System (ASC) final rule, the Centers for Medicare and Medicaid Services (CMS) included a new billing code for a dental surgical procedure in outpatient hospitals, increasing reimbursement rates for these services from $200 to about $2,000.

CMS also included more than 25 new dental billing codes for dental surgical procedures in ASCs as part of the 2024 OPPS and ASC final rule, allowing more oral health services to be offered in more health care settings.

For 2024, CMS is finalizing Medicare payment rates under the OPPS for over 240 dental codes to align with the dental payment provisions in the 2023 Physician Fee Schedule final rule by assigning them to clinical Ambulatory Payment Classifications (APCs). According to CMS, assigning additional dental codes to clinical APCs will result in greater consistency in Medicare payment for different sites of service and help ensure patient access to dental services performed in the hospital outpatient setting when payment and coverage requirements are met.

Also for 2024, to address patient access issues for dental services under anesthesia in the ASC setting, CMS is finalizing adding 26 separately payable dental surgical procedures to the ASC Covered Procedures List (CPL) and 78 ancillary dental services to the list of covered ancillary services.