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-25 - Dental Services and Reimbursement Methodology
Subsection 144-101-II-25.07 - BILLING INSTRUCTIONS
Providers that attest to and bill for services under Section 25, Dental Services, shall not bill claims containing Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes for covered services described in Section 25.03.
If a provider that attests to Section 25 provides a service that is within their scope of practice that is not covered under Section 25.03, but is covered under another Section of the MBM, the provider must comply with the relevant Section of the MBM which authorizes coverage of that service and may bill for the service using the appropriate CPT or HCPCS code(s).
Providers shall bill in accordance with the Department's current billing instructions. Billing instructions are available upon request or from the Department's website at: https://mainecare.maine.gov/Billing%20Instructions/Forms/Publication.aspx.
