CMS adds new DQA quality measure for oral evaluations during pregnancy

Provisional measure will become mandatory for state Medicaid reporting in 2026

The Centers for Medicare & Medicaid Services has added receiving an oral evaluation while pregnant as a new quality measure for Medicaid and the Children’s Health Insurance Program.

Oral Evaluation During Pregnancy: Ages 15 to 20 is a provisional measure in 2025, but it will be included in mandatory state reporting next year as part of the 2026 Core Set of Children’s Health Care Quality Measures.

The measure, developed by the Dental Quality Alliance, will be the fourth DQA measure to be included in the Child Core Set. It recognizes the important connection between oral health and overall health during pregnancy and addresses an identified gap in the Child Core Set, according to a letter from CMS announcing core set changes for 2026.

“The addition of another DQA measure to the CMS core sets is a testament to the rigorous process undertaken in DQA measure development and the utility of DQA measures at a national level,” said DQA Chair Julie Reynolds, D.D.S. “It will be a valuable addition to help state Medicaid programs better understand and improve dental care use in pregnant youth, a population for whom dental care access is so critically important.”

The Child Core Set and the Core Set of Adult Health Care Quality Measures for Medicaid, or the Adult Core Set, are reviewed annually by CMS, state Medicaid and CHIP agencies, health care providers, health plans and patient advocates. This periodic reassessment is necessary because changes in clinical guidelines, experiences with reporting and performance rates could warrant modifying the quality measures, according to the letter.

Find the core sets at medicaid.gov.