By Dr. Mark W. Jurkovich, HealthPartners

Updates on Quality Measures & Enhance CDT proposals

What’s happened to quality measures?

For many of our NADP members, quality measures have not been key reporting or administrative considerations.  That is beginning to change and change quite quickly. It likely needs to be on the radar of any dental plan providing administration for public programs and those working with medical plans.  We are also beginning to see more public reporting or commercial results as well, as witnessed in Wisconsin through the Wisconsin Collaborative for Health Care Quality (WCHQ).

Currently, the Dental Quality Alliance (DQA) has information that 35 different states are now requiring reporting of at least a few of the DQA measures to CMS.  In 2024, CMS is requiring all states to report on a couple of the DQA measures.

Additionally, since HEDIS announced that some dental measures would be included, health plans have begun reaching out to the American Dental Association (ADA) to see how they can report on these (due to their lack of familiarity and use of CDT codes).  Thus, for those members who provide services to either health plans or health care systems that already do medical reporting, your input and methods for reporting dental measures will be very important to them.

Administrative adjustments may be necessary for your systems and to identify necessary methods to provide information to the various agencies you may need to deal with at both the state and national level.  Beginning to evaluate these needs sooner, rather than later, might save both angst and money going forward.

ADA’s Enhanced CDT Proposals

The ADA has been holding meetings of their Enhanced CDT Task Force over the past year with representatives of the ADA, NADP, clearinghouses and the dental benefits industry. The ADA held listening sessions earlier but received very limited feedback during those sessions.

The ADA has announced examples and draft modifier sets of an Enhanced CDT by procedure category (restorative, prosthodontics, periodontics, etc.). These should be available for review about the 2nd week of November on for public comment. An article announcing this public comment period will be published in ADA News at that time. The review period will remain open from November through March 2023. NADP will share more details as received.


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