LD 2123

APPROVED  CHAPTER
  APRIL 15, 2026  164
  BY GOVERNOR  RESOLVES
  STATE OF MAINE
  _____
  IN THE YEAR OF OUR LORD
  TWO THOUSAND TWENTY-SIX
  _____
  H.P. 1438 - L.D. 2123
   Resolve, to Improve Dental Care Access by Modifying the MaineCare
  Reimbursement Methodology for the Provision of Certain Dental Services
   Sec. 1. Department of Health and Human Services to remove requirement
for prior authorization for deep sedation or general anesthesia for dental
services. Resolved: That, effective July 1, 2026, the Department of Health and Human
Services shall provide that prior authorization may not be required for the provision of deep
sedation or general anesthesia for dental services to MaineCare members.
   Sec. 2. Department of Health and Human Services to modify fee schedule;
reimbursement rates for anesthesia provided for dental services. Resolved:
That, effective July 1, 2026, the Department of Health and Human Services shall update
the department's fee schedule for MaineCare reimbursement for dental services as follows:
    1. The reimbursement rate for deep sedation and general anesthesia for dental services
must be established at 67% of the commercial median benchmark and this rate must, at a
minimum, be maintained until June 30, 2028 or until rates established pursuant to a dental
rate determination conducted according to the Maine Revised Statutes, Title 22, section
3173-J are effective, whichever is sooner; and
    2. Deep sedation and general anesthesia services must be billed using current dental
terminology codes D9222, D9223, D9224 and D9225.
   Sec. 3. Department of Health and Human Services to modify fee schedule;
reimbursement rates for certain dental services. Resolved: That the Department
of Health and Human Services shall provide for the following in its fee schedule for
MaineCare reimbursement for dental services:
    1. The temporary reimbursement rates for tooth extractions billed using current dental
terminology code D7140 must, at a minimum, be maintained until June 30, 2028 or until
rates established pursuant to a dental rate determination conducted according to the Maine
Revised Statutes, Title 22, section 3173-J are effective, whichever is sooner; and
    2. The temporary reimbursement rate for dental caries arresting medicament
application billed using current dental terminology code D1354 must, at a minimum, be
maintained until June 30, 2028 or until rates established pursuant to a dental rate
  Page 1 - 132LR2747(03)
determination conducted according to the Maine Revised Statutes, Title 22, section 3173-J
are effective, whichever is sooner.
    Sec. 4.    Appropriations and allocations. Resolved: That the following
appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers 0147
Initiative: Provides funding for the Department of Health and Human Services to prohibit
requirements for prior authorization for deep sedation or general anesthesia for dental
services provided to MaineCare members and establish a reimbursement rate for these
services at 67% of the commercial median benchmark.
GENERAL FUND  2025-26  2026-27
 All Other  $0  $17,580
  __________      __________
GENERAL FUND TOTAL  $0  $17,580
FEDERAL EXPENDITURES FUND  2025-26  2026-27
 All Other  $0  $31,647
  __________      __________
FEDERAL EXPENDITURES FUND TOTAL  $0  $31,647
FEDERAL BLOCK GRANT FUND  2025-26  2026-27
 All Other  $0  $5,787
  __________      __________
FEDERAL BLOCK GRANT FUND TOTAL  $0  $5,787
    Sec. 5. Retroactivity. Resolved: That this resolve applies retroactively to July 1,
2026.
  Page 2 - 132LR2747(03)