CMS Releases Annual Payment Rules

  • by AGD Washington Advocacy Representative
  • Jul 25, 2023
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released two proposed rules, the Calendar Year (CY) 2024 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule (CMS 1786-P) and the Calendar Year (CY) 2024 Medicare Physician Fee Schedule (PFS) Proposed Rule (CMS-1784-P). These annual payment rules include numerous proposals to revise Medicare payment. Specifically, the CY 2024 PFS proposed rule includes a proposal to expressly identify instances where dental services are inextricably linked, substantially related, and integral to the clinical success of other services covered under Medicare Parts A and B. The CY 2024 OPPS/ASC proposed rule includes proposals to: (1) add 26 dental surgical procedures to the ASC covered procedures list; (2) assign 229 HCPCS codes describing dental services to various clinical Ambulatory Payment Classifications (APCs); and (3) package payments for dental services when they are performed with another covered dental or medical service. 

Impact on General Dentistry: AGD policy opposes the inclusion of dental benefits in Medicare. AGD will provide comments on the proposed rules by the September 11, 2023, deadline.