CMS Releases Physician Fee Schedule Proposed Rule
On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released its Calendar Year (CY) 2026 proposed rule for the Medicare Physician Fee Schedule (PFS). In the proposed rule, CMS proposed changes to the physician payment conversion factor and included other key updates that impact primary care and Medicare services.
In the CY 2023 PFS final rule, CMS clarified that Medicare payment under Parts A and B could be made for dental services delivered in inpatient or outpatient settings when the dental services are “inextricably linked to, and substantially related and integral to the clinical success of, other covered services.” The agency also established a process by which it considers public recommendations to identify these dental services. In the CY 2026 PFS proposed rule, CMS stated that it will not be making any proposals in response to the submissions it received.
The CY 2026 PFS proposed rule can be found here.
Impact on General Dentistry: The AGD monitors any potential broadening of the circumstances in which Medicare payment is allowed for dental services to review against AGD policy. It is important for patients experiencing significant health issues to be able to access needed dental services in circumstances where their relationship is integral to the treatment of already covered Medicare physician/dentist services, without opening the door to a full Medicare dental benefit.
In the CY 2023 PFS final rule, CMS clarified that Medicare payment under Parts A and B could be made for dental services delivered in inpatient or outpatient settings when the dental services are “inextricably linked to, and substantially related and integral to the clinical success of, other covered services.” The agency also established a process by which it considers public recommendations to identify these dental services. In the CY 2026 PFS proposed rule, CMS stated that it will not be making any proposals in response to the submissions it received.
The CY 2026 PFS proposed rule can be found here.
Impact on General Dentistry: The AGD monitors any potential broadening of the circumstances in which Medicare payment is allowed for dental services to review against AGD policy. It is important for patients experiencing significant health issues to be able to access needed dental services in circumstances where their relationship is integral to the treatment of already covered Medicare physician/dentist services, without opening the door to a full Medicare dental benefit.