Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 405.000 - Community Health Center Services
Section 405.473 - Fluoride Varnish Services
Current through Register 1531, September 27, 2024
(A) Eligible Members. Members must be younger than 21 years old to be eligible for the application of fluoride varnish.
(B) Qualified Personnel. Physicians, physician assistants, certified nurse practitioners, registered nurses, licensed practical nurses, and medical assistants may apply fluoride varnish subject to the limitation of state law. To qualify to apply fluoride varnish, the individual must complete a MassHealth-approved training on the application of fluoride varnish, maintain proof of completion of the training, and provide such proof to the MassHealth agency upon request.
(C) Billing for a Medical Visit and Fluoride Varnish Treatment or Procedure. A CHC may bill for fluoride varnish services provided by a physician or a qualified staff member as listed in 130 CMR 405.473(B) under the supervision of a physician. The CHC may bill for a medical visit in addition to the fluoride varnish application only if fluoride varnish was not the sole service, treatment, or procedure provided during the visit. The dental enhancement fee may not be billed for a fluoride varnish application separately or in addition to a medical visit.
(D) Claims Submission. A CHC may submit claims for fluoride varnish services that are provided by physicians, physician assistants, certified nurse practitioners, registered nurses, licensed practical nurses, and medical assistants according to 130 CMR 405.473(C). See Subchapter 6 of the Community Health Center Manual for service codes.
