Will Medicare Part B pay for a root canal and cap?

A fellow caregiver asked...

I was in a restaurant eating and my molar broke off at the base of my gum. I had to have a root canal, then the dentist had to go below the gum line to attach a cap to cover the space. Will Medicare Part B cover the procedure?

Expert Answer

Almost certainly not. The fact that the procedure for replacing your tooth involved work below the gum line does not change the treatment from dental (not covered by Medicare Part B) to medical (covered by Medicare Part B). Medicare Part B can cover non-physician treatment (by an oral or maxillofacial surgeon, for example) involving an injury, disease, or condition of jaw or mouth bones or tissue only if it's the kind of treatment that physicians also perform. Otherwise, it remains dental care and is not covered. Of course, it doesn't hurt to ask your dentist whether there is some very unusual circumstance that would make it worthwhile to submit a bill to Medicare. (And even this would require that your dentist participate in Medicare, which many dentists do not.) But don't count on it.