Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter II - Specific Policies By Service
Section 144-101-II-15 - Chiropractic Services
Subsection 144-101-II-15.06 - LIMITATIONS

A. Unless otherwise indicated in this Section, reimbursement for chiropractic services for MaineCare members ages twenty-one (21) and over shall be limited to twelve (12) visits per calendar year and based upon medical necessity. For services beyond twelve (12) visits, all eligible MaineCare members twenty-one (21) and over require prior authorization as indicated in Section 15.07-2(B).

B. Reimbursement and limitations on the number of x-rays will be based upon the criteria of medical necessity and documentation as specified in Section 15.07, Policies and Procedures.

C. When repeat x-ray examinations of the spine for the same condition are required because of technical or professional error in the original x-rays, such repeat x-rays are not a covered service and are not reimbursable by MaineCare.