WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services is urging state Medicaid programs to restrict or eliminate coverage for mercury-containing dental fillings, a federal push that could shift publicly funded dental care toward resin-based alternatives.
CMS sent the guidance to every state Medicaid director, according to the Department of Health and Human Services. The notification recommends ending or limiting reimbursement for dental amalgam procedure codes or creating incentives for providers to use mercury-free composite fillings.
Dental amalgam combines mercury with other metals and has long been used to fill cavities. HHS cited potential health risks for vulnerable groups and broader environmental concerns as the basis for the requested policy changes.
“Taxpayer dollars should support the safest care available—not yesterday’s materials,” HHS Secretary Robert F. Kennedy Jr. stated. “It’s time to turn the page on dental amalgam and help every state move toward safer, mercury-free care.”
The federal government is recommending that states restrict or end coverage for amalgam codes D2140 through D2161. CMS also pointed states toward resin-based composite codes D2330 through D2394.
The notification indicated that states could generally make the change without amending their Medicaid state plans because those plans typically do not specify coverage at the individual procedure-code level.
CMS Administrator Dr. Mehmet Oz described the request as part of an effort to improve the safety of Medicaid-funded dental care.
“This is a straightforward and meaningful step that reflects our shared commitment to safe, higher quality care for all Americans,” Oz stated.
HHS identified pregnant women, developing fetuses, women seeking to become pregnant, children younger than 6, people with neurological conditions and individuals with impaired kidney function among the populations that may face elevated risks from mercury exposure associated with dental amalgam.
The state guidance follows a February decision by the Indian Health Service to stop using mercury-containing amalgam at its facilities by 2027.
CMS also cited the Minamata Convention on Mercury, an international agreement to which the United States is a party. Participating countries committed in November 2025 to phase out dental amalgam use by 2034.
The notification is advisory rather than a federal prohibition, leaving individual states to determine whether and how to change their Medicaid coverage policies.
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