Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.45 - Dental Network Adequacy
Section 31.10.45.03 - Travel Distance Standards
Universal Citation: MD Code Reg 31.10.45.03
Current through Register Vol. 51, No. 19, September 20, 2024
A. Sufficiency Standards.
(1) Using the zip code list on the Maryland Insurance Administration's website, each provider panel of a carrier shall have within the geographic area served by the carrier's network or networks, sufficient dentists, including specialty providers, and facilities to meet the maximum travel distance standards listed in the chart under §A(2) of this regulation for each type of geographic area measured from the enrollee's place of residence.
(2) Chart of Travel Distance Standards.
|
Urban Area Maximum Distance (miles) |
Suburban Area Maximum Distance (miles) |
Rural Area Maximum Distance (miles) |
|
|
Provider type: |
|||
|
General dentist |
15 |
30 |
60 |
|
Endodontic |
30 |
45 |
75 |
|
Orthodontics and dentofacial orthopedics |
30 |
45 |
75 |
|
Oral and maxillofacial pathology |
30 |
45 |
75 |
|
Oral and maxillofacial radiology |
30 |
45 |
75 |
|
Oral and maxillofacial surgery |
30 |
45 |
75 |
|
Pediatric dentistry |
30 |
45 |
75 |
|
Periodontic |
30 |
45 |
75 |
|
Prosthodontics |
30 |
45 |
75 |
B. Each provider panel of a carrier shall include at least 20 percent of the available essential community providers who provide dental services in each of the urban, rural, and suburban areas.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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