Temporomandibular Disorders - Medicare Advantage

Covers evaluation and management of temporomandibular disorders (TMD/TMJ), including conservative therapies (self‑management, medications, intraoral splints), adjunctive behavioral or physical therapy, and select TMJ surgical procedures (e.g., arthrocentesis, arthroscopy, arthroplasty) when indicated. Applicable to patients with jaw pain, clicking/locking, dysfunction or TMD related to arthritis, bruxism, trauma, connective tissue disease or malalignment, but requires documented conservative treatment failure for ≥3 months, an appropriate history/physical (imaging for severe/persistent cases), adherence to Medicare “reasonable and necessary” criteria, and has specified limits (behavior therapy only with comorbid depression/anxiety/stress; PT primarily for cervical/shoulder symptoms).

"21299 Unlisted craniofacial and maxillofacial procedure (as related to temporomandibular joint)"