Why Medicare Deadlines Matter for Dentists

Even though Medicare Part B covers very few dental services, ignoring the June 1, 2015 and December 1, 2015 Medicare deadlines can have a profoundly negative impact on your dental practice.

If you never see Medicare eligible patients, you are in the small minority of dentists who do not have to take action regarding Medicare enrollment deadlines. If you do see Medicare eligible patients, namely people 65 years or older, you have some important decisions to make.shutterstock_92524372

Starting June 1, 2015, Medicare will no longer accept claims for Medicare covered dental services unless the dentist is enrolled as a participating or non-participating provider with Medicare. Which dental services are covered by Medicare? Not much. The most common are biopsies for oral cancer, reconstruction of the jaw following an accident or disease, extractions with radiation treatment of the jaw, and exams prior to kidney transplants or heart valve replacement. Medicare may also cover sleep apnea devices.

If after reading that list and doing additional research you realize you never provide any Medicare covered services to your Medicare eligible patients, you may think you can simply join the group of dentists who do not have to take action regarding enrollment deadlines. Unfortunately, that is incorrect.

Starting June 1, 2015, if you refer out Medicare covered services to another provider, that provider cannot bill Medicare for reimbursement if you are not enrolled in Medicare. Also, starting December 1, 2015, if you ever write prescriptions for your Medicare patients, which most dentists do, Medicare will not reimburse patients for prescription costs unless you are enrolled in Medicare.shutterstock_207314821

Why has Medicare roped dentists into enrollment? This is part of a larger effort by Medicare to combat fraud and abuse and to save money. Despite objections by the ADA, dentists are included in this effort. That is why the June 1 and December 1, 2015 deadlines matter. If you ignore these deadlines, your Medicare eligible patients may encounter some expensive and unwanted surprises.

Fortunately, there are options that allow you to enroll in Medicare just to write prescriptions and refer out services without having to worry about billing Medicare for anything. This is the course of action most dentists will want to take. We will cover this enrollment option along with others in next week’s blog.

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