Expanding coverage of dental procedures for Medicare beneficiaries with certain medical treatments appeared to not encourage clinicians, especially oral surgeons, to participate in the program. The study was published in the Journal of the American Dental Association.
However, researchers were unable to access claims volume or patient outcome data, which are necessary to assess the effect of Medicare dental reforms on patients.
“Dentists may remain hesitant to participate in Medicare or are unaware of the new policies,” wrote the authors, led by Kamyar Nasseh, PhD, of the ADA’s Health Policy Institute in Chicago (JADA, January 29, 2026).
In November 2022, the U.S. Centers for Medicare and Medicaid Services (CMS) adopted a rule expanding access to dental care by finalizing payment for services deemed “integral to covered medical services.” Under this rule, Medicare began in 2023 paying for services, including dental exams and treatment to or simultaneously with organ transplants, valvuloplasty procedures, and cardiac valve replacements.
In 2024, access was expanded to beneficiaries with head and neck cancer, those receiving high-dose antiresorptive therapy or chimeric antigen receptor T-cell therapy as cancer treatment, and beneficiaries receiving oral healthcare screenings before chemotherapy.
Because of these reforms, it was estimated that 2.6 million Medicare beneficiaries would be eligible for dental services. Also, the expansion triggered a need for more dentists to participate in Medicare to treat these patients, according to the study.
To determine the effects of this dental reform, monthly counts of the number of Medicare-billing dentists were gathered from CMS’ “Doctors and Clinicians” files from January 2021 to December 2024, the authors reported. A single-group interrupted time-series analysis was estimated separately for all dentists, oral surgeons, and non-oral surgeons to assess any correlation between expanding Medicare and provider participation, the authors wrote.
Most dentists billing Medicare were oral surgeons. Prior to the changes, 88% were in the period before the changes in 2023, and it was 83.7% after the second expansion in 2024.
The mean number of Medicare-billing dentists fell from 2,033 (95% confidence interval [CI], 1,993 to 2,074) before the reforms to 1,615 (95% CI, 1,607 to 1,623) after the expansions, they wrote.
Furthermore, the same type of decrease was seen in Medicare-billing oral surgeons. The number of oral surgeons declined from 1,790 (95% CI, 1,748 to 1,831) before the changes to 1,351 (95% CI, 1,347 to 1,356) after the second expansion in 2024.
However, the study had limitations. The “Doctors and Clinicians” billing provider data covered providers participating in traditional Medicare, not Medicare Advantage, the authors wrote.
“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,” Nasseh and colleagues wrote.
