I am reaching out to seek clarification on the application of the BMI Screening and Follow-Up Plan measure (CMS69v12) for dental-only patients. As the Chief Dental Officer at a Federally Qualified Health Center (FQHC), I want to bring to your attention some practical challenges we face in applying this measure within a dental setting.

A significant portion of our dental patients have primary care providers (PCPs) who are external to our organization. In these cases, we are not typically in a position to manage follow-up care for BMI screenings, particularly when a patient's BMI is outside of normal parameters. Taking BMI measurements in our dental clinics, only to be unable to provide the appropriate referrals or follow-up care due to the patient's external PCP, does not align with the standard dental workflow.

Additionally, our dental clinics are not equipped with nursing stations or the infrastructure to regularly take height and weight measurements, as this is not customary in the dental setting. This creates a disconnect between the expectations of the BMI measure and the reality of care provided in a dental-only context.

Given these challenges, I am requesting that your organization consider an exception or carve-out for dental-only patients in this measure. Without such an exemption, our health center's performance may not accurately reflect our quality of care, as we lack both the infrastructure and the appropriate care pathways to address BMI-related concerns for these patients.

I appreciate your time and consideration of this issue and look forward to your guidance on how best to address these concerns in a way that recognizes the unique nature of dental care.