Provider Dental Forums
July 30, 2024 Dental Provider Forum
Topics covered:
- Services covered and underutilized
- Claims and billing updates
- Who to contact and when
- Early and Periodic Screening, Diagnosis, and Treatment services (EPSDT) resources now available
- Addressing challenges and barriers to accessing dental services
Forum materials:
July 30, 2024 Dental Provider Forum
Topics covered:
- Forum Follow-up
- New Dental Services Webpage
- Questions & Answers Document
- Claims
- Federal Regulations
Forum materials:
Enroll with MaineCare
See the Enrollment & Revalidation webpage for information about enrolling with MaineCare including rationale to enroll, an overview about the steps to enroll, enrollment requirements, and more.
Questions & Answers
Providers asked the questions found in the Dental Services Questions & Answers (PDF) during the Provider Dental Forums.
Provider Training
See the Event Calendar on the Health PAS Online Portal for information and to register for a Dental ADA Claim training. This training is generally offered every two months.
Claims & Billing
- Health PAS Online Portal – Log into the portal to submit prior authorizations and claims.
- Supplemental Billing folder on the Health PAS Online Portal for Section 25 Billing Guidance.
Request Code Coverage
Use the Code Request Form (PDF) to request a code be covered by MaineCare.
MaineCare encourages the use of the code request form, however, completing the form does not guarantee coverage of the code under your contract. We will advise you why a code cannot be added if the request is denied. We will also make note of any codes that we are unable to add for further review during future rulemaking. See the Code Request Form Training Video for instructions for completing the form.
Services for Children and Youth
MaineCare's Early and Periodic Screening Diagnosis & Treatment (EPSDT) program allows children and youth under age 21 to receive medically necessary services or equipment that are not typically covered in the MaineCare Benefits Manual (MBM) due to limits on the type, frequency, or duration of the service. For more information regarding EPSDT, visit MaineCare's Children's Services webpage.
Current Dental Rates
See the Section 25 Fee Schedule for MaineCare's current rates.
MaineCare Dental Reform
- Draft Billing Guidance (PDF) - updated June 17, 2022
- List of Comprehensive Adult Dental Services (PDF) - June 27, 2022
- MaineCare Dental Metrics (PDF) - Historical Baseline Report
- MaineCare Dental Metrics (PDF) - January 2024
For details about section 25 rate reform, see the Rate Reform webpage.
MaineCare Bulletins
Sign up to receive e-messages from MaineCare. You can select the “MaineCare – Dental Services” topic list to receive only messages for dental service providers.
Contact Us
For details about who to call for specific topics, see the Contacts for Providers (PDF).