MaineCare Benefits Manual, Section 90, Physicians Services

Date posted:

AGENCY: Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 90, Physicians Services

NATURE OF PROPOSED CHANGES: The Department plans to add reimbursement for Current Dental Terminology (CDT) code D1354 (Application of caries arresting medicament-per tooth) effective May 1, 2023. The Department will reimburse this service consistent with the recently adopted Dental Services methodology in the Maine Medicaid State Plan. Effective May 1, 2023, reimbursement is equal to $25.70.

REASON FOR PROPOSED CHANGES: The Department is adding reimbursement to align with recently adopted changes to Section 25 - Dental Services in order to ensure consistent reimbursement for like services.

ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will cost a total of $14,518 in Federal Fiscal Year 2023, including $9,697 in federal dollars and $4,822 in state dollars and $34,844 in Federal Fiscal Year 2024, including $22,016 in federal dollars and $12,828 in state dollars.

ACCESS TO PROPOSED CHANGES AND COMMENTS TO PROPOSED CHANGES: The public may review the proposed methodology changes and written comments at any Maine DHHS office in every Maine county. To find out where the Maine DHHS offices are located, call 1-800-452-1926.


AGENCY NAME: Office of MaineCare Services

ADDRESS: 109 Capitol Street, 11 State House Station

                    Augusta, Maine 04333-0011

TELEPHONE: (207) 624-4006 FAX: (207) 287-6106

TTY: 711 Maine Relay (Deaf or Hard of Hearing)

State Plan Amendment

Office: MaineCare Services


Comment deadline:

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