Summary & Overview
HCPCS G0067: Dentistry MIPS Specialty Set
HCPCS Level II code G0067 denotes the Dentistry MIPS specialty set, a designation for dental provider reporting under Medicare's Merit-based Incentive Payment System. Nationally, this code matters as dentistry increasingly integrates quality measurement and value-focused reporting into routine practice, affecting performance assessment and payer reporting requirements across public and commercial plans. Primary payers relevant to this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication explains what G0067 represents, the clinical and practice settings where it applies, and why it matters for dental providers and payers nationwide. Readers will find benchmarks and performance context where available, an overview of payer coverage considerations, policy and coding implications for dental quality reporting, and clinical context for how dentistry-specific MIPS measures are applied. The document highlights gaps where input data is not available and clarifies what information is included and omitted. The focus is national in scope and intended for clinicians, practice managers, and policy analysts seeking a clear summary of the code's purpose and operational implications.
Billing Code Overview
HCPCS Level II code G0067 represents the Dentistry MIPS specialty set. This code is used to denote services and reporting related to dentistry-specific Merit-based Incentive Payment System (MIPS) quality and performance measures.
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Service type: Dental quality reporting and performance measurement activities
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Typical site of service: Dental offices and other ambulatory dental care settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult receiving dental quality reporting under the Merit-based Incentive Payment System (MIPS) for a dental specialty practice. The patient presents for a comprehensive dental visit where the dental clinician documents preventive, diagnostic, and restorative services performed during the visit for MIPS reporting purposes. Clinical workflow: registration and verification of insurance and MIPS participation; collection of patient history and informed consent; intraoral examination, radiographs as indicated, and periodontal assessment; provision of preventive or restorative procedures (e.g., prophylaxis, fillings, extractions) as clinically indicated; documentation of quality measures and submission of the dentistry MIPS specialty set when reporting performance measures for the clinician or group. Typical site of service: outpatient dental clinic or private dental office. Typical modifiers that may be appended relate to unusual services, bilateral procedures, reduced services, or anesthesia; payors involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work required to provide a service is substantially greater than typically required. |
23 |