CMS Urges State Medicaid Programs to Phase Out Mercury Dental Amalgam Fillings

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Posted: July 24, 2026

CMS Urges State Medicaid Programs to Phase Out Mercury Dental Amalgam Fillings

Edited by Dentaltown staff

The Centers for Medicare and Medicaid Services has urged every state Medicaid program to restrict or end coverage for mercury-containing dental amalgam fillings, a shift announced July 22 that could reshape restorative material selection for millions of publicly insured patients.

In a notification sent to all state Medicaid directors, CMS said programs should consider restricting or ending reimbursement for amalgam procedure codes D2140–D2161, or encouraging providers to use resin-based composite codes D2330–D2394. The agency said a formal state plan amendment is likely unnecessary, because state plans do not typically specify coverage at that level of detail, which leaves implementation to each state.

The Department of Health and Human Services cast the move as part of a wider effort to remove mercury from routine care, citing health and environmental concerns. HHS Secretary Robert F. Kennedy Jr. said, “Mercury has no place in the mouths of our children.” CMS Administrator Mehmet Oz described the step as a straightforward way to support safer, higher-quality care.

The guidance is advisory rather than a binding national ban. HHS pointed to the Indian Health Service, which plans to eliminate amalgam in its facilities beginning in 2027, and to the Minamata Convention on Mercury, whose parties agreed in November 2025 to phase out dental amalgam worldwide by 2034.

The CMS position moves ahead of current FDA guidance. The FDA does not support a ban on dental amalgam and recommends that higher-risk groups, including children younger than 6, pregnant and nursing women, and people with neurological or kidney conditions, avoid it when possible and appropriate. The agency also advises against removing sound existing amalgam restorations unless medically necessary.

Because the notification is guidance, its practical effect will depend on decisions by individual state Medicaid agencies.

Sources:
U.S. Department of Health and Human Services, “Trump Administration Encourages States to End Mercury-Containing Dental Fillings,” July 22, 2026: hhs.gov/press-room/mercury-containing-dental-fillings
U.S. Food and Drug Administration, “Dental Amalgam Fillings Recommendations – Graphics”: fda.gov/medical-devices/dental-amalgam-fillings-recommendations


CMS Urges State Medicaid Programs to Phase Out Mercury Dental Amalgam Fillings

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