Sec. 101. Coverage of dental services under the Medicare program
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Section 1861(s)(2) of the Social Security Act ( 42 U.S.C. 1395x(s)(2) ) is amended— in subparagraph (EE), by striking and after the semicolon at the end; in subparagraph (FF), by adding and after the semicolon at the end; and by adding at the end the following new subparagraph: dental services (as defined in subsection (iii)); . Section 1861(s) of the Social Security Act (42 U.S.C. 1395x(s)) is amended by adding at the end the following new subsection: The term dental services means oral health services (as defined by the Secretary) provided by a licensed oral health care provider that are necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.
For purposes of paragraph (1), such term shall include mobile and portable oral health services (as defined by the Secretary) that— are provided for the purpose of overcoming mobility, transportation, and access barriers for individuals; and satisfy the standards and certification requirements established under section 1902(a)(84)(B) for the State in which the services are provided. . Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended— by striking and before
(Z); and by inserting before the semicolon at the end the following: , and
(AA)with respect to dental services (as defined in section 1861(iii)), the amount paid shall be
(i)in the case of such services that are dental health preventive services described in paragraph (1)(D) of such section, 100 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848, and
(ii)in the case of all other such services, 80 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848 . Section 1848(j)(3) of the Social Security Act ( 42 U.S.C. 1395w–4(j)(3) ) is amended by inserting (2)(GG), after risk assessment), . Section 1861(s)(8) of the Social Security Act ( 42 U.S.C. 1395x(s)(8) ) is amended— by striking (other than dental) and inserting (including dentures) ; and by striking internal body . Section 1862(a) of the Social Security Act ( 42 U.S.C. 1395y ) is amended by striking paragraph (12). The amendments made by this section shall apply to services furnished on or after January 1, 2014.
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- 42 USC 1395w–4(j)(3)
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Sec. 101
Coverage of dental services under the Medicare program
Cite42 USC 1395w–4(j)(3)
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