Hi Guest!

Great question. Unfortunately, if the patient has already been diagnosed with TMD, we generally see Medicare denying coverage for those services. If the patient is being evaluated for pain, then we do see reimbursement from Medicare Part B for services such as office visits and xrays.

There may be some coverage available through the Medigap or secondary if available, but would certainly recommend performing a benefit verification to see first :)

Hope this helps!

Hi Guest!

We do not see many occlusal orthotic appliances covered by Medicare Part B. Some Medicare policies state that they may consider reimbursement based on coding of symptoms.

Medicare also states Oral occlusal appliances used to treat temporomandibular joint (TMJ) disorders are coded D7880 - occlusal orthotic appliance. Claims for these devices should not be submitted to the DME MACs.

Hope this helps!