Maine Medicaid Dental Coverage Guide
Maine Medicaid Dental Coverage Guide: verify the Maine authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
Maine Medicaid Dental Coverage Guide: verify the Maine authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. Maine Medicaid pays a dentist $72.05. Maine Medicaid pays a dentist $35.05.
What this page recommends
Maine Medicaid Dental Coverage Guide: verify the Maine authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
- Next step: Find a Provider
What should I verify before acting?
Verify the local workflow, provider fit, pricing details, and timing directly through the canonical guide or a qualified professional before making a decision.
Related decision paths people also use
These are nearby ways people describe the same decision before they move into local comparison, pricing, or urgent next-step mode.
Maine Medicaid dental reimbursement rates on this page are taken from MaineCare Section 25, Dental Services Rates, published by Maine Department of Health and Human Services (MaineCare), and retrieved 2026-08-26. The schedule is effective 2026-01-01. Every amount shown is what the state pays a dental provider for the procedure. It is not a price a patient pays, and self-pay and insured prices are typically far higher. Maine operates a comprehensive adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
Maine Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What Maine Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | Maine Medicaid pays a dentist $72.05 | State reimbursement, effective 2026-01-01 |
| Periodic oral exam (CDT D0120) | Maine Medicaid pays a dentist $35.05 | State reimbursement, effective 2026-01-01 |
| Crown, porcelain/ceramic (CDT D2740) | Maine Medicaid pays a dentist $622.35 | State reimbursement, effective 2026-01-01 |
| Root canal, molar tooth (CDT D3330) | Maine Medicaid pays a dentist $1,005.02 | State reimbursement, effective 2026-01-01 |
| Extraction, erupted tooth (simple) (CDT D7140) | Maine Medicaid pays a dentist $120.69 | State reimbursement, effective 2026-01-01 |
| Comprehensive oral exam (CDT D0150) | Maine Medicaid pays a dentist $67.13 | State reimbursement, effective 2026-01-01 |
| Cleaning (prophylaxis), child (CDT D1120) | Maine Medicaid pays a dentist $55.20 | State reimbursement, effective 2026-01-01 |
| Fluoride varnish (paediatric preventive) (CDT D1206) | Maine Medicaid pays a dentist $26.85 | State reimbursement, effective 2026-01-01 |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | Maine Medicaid pays a dentist $33.56 | State reimbursement, effective 2026-01-01 |
| Amalgam filling, one surface (CDT D2140) | Maine Medicaid pays a dentist $85.59 | State reimbursement, effective 2026-01-01 |
| Composite filling, one surface, posterior (CDT D2391) | Maine Medicaid pays a dentist $112.78 | State reimbursement, effective 2026-01-01 |
| Crown, porcelain fused to high noble metal (CDT D2750) | Maine Medicaid pays a dentist $698.15 | State reimbursement, effective 2026-01-01 |
| Crown, porcelain fused to predominantly base metal (CDT D2751) | Maine Medicaid pays a dentist $534.30 | State reimbursement, effective 2026-01-01 |
| Root canal, anterior tooth (CDT D3310) | Maine Medicaid pays a dentist $632.52 | State reimbursement, effective 2026-01-01 |
| Root canal, premolar tooth (CDT D3320) | Maine Medicaid pays a dentist $747.46 | State reimbursement, effective 2026-01-01 |
| Complete denture, upper (CDT D5110) | Maine Medicaid pays a dentist $751.02 | State reimbursement, effective 2026-01-01 |
| Complete denture, lower (CDT D5120) | Maine Medicaid pays a dentist $751.02 | State reimbursement, effective 2026-01-01 |
| Bridge retainer crown, porcelain fused to high noble metal (CDT D6750) | Maine Medicaid pays a dentist $667.66 | State reimbursement, effective 2026-01-01 |
| Surgical extraction, erupted tooth (CDT D7210) | Maine Medicaid pays a dentist $147.68 | State reimbursement, effective 2026-01-01 |
Ready to compare providers?
Use the source-backed framework above, then continue to the matching provider destination.
Verify the rule before acting
- State Medicaid and CHIP Profiles — State-specific Medicaid and CHIP program profile; reviewed 2026-08-26
- Dental Care — Federal dental benefit requirements and state-option context; reviewed 2026-08-26
- Dental Licensure by State — State dental board and licensure pathway discovery; reviewed 2026-08-26
- MaineCare Section 25, Dental Services Rates — Official Maine Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- Maine Medicaid adult dental benefit scope — Maine's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
Maine publishes its Medicaid dental reimbursement rates in MaineCare Section 25, Dental Services Rates. Those rates are what Maine Medicaid pays a dental provider for each procedure, and they are not prices a patient pays. A self-pay or insured price for the same procedure is normally much higher, so a Maine reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what Maine Medicaid will pay a dentist who accepts it. The figures on this page were retrieved 2026-08-26.
Quick checklist
- Record the event date and the decision deadline for the Maine issue.
- Select Maine in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Capture the operative rule, not merely a search-result snippet.
- Use Find a Provider if interpretation or application remains uncertain.
Red flags
- A stale screenshot used as the only evidence
- No distinction between federal and Maine requirements
- A recommendation based only on advertising position
Adult and child dental benefits are set differently in Maine. Children's dental coverage is federally required under EPSDT, so every state must cover medically necessary dental care for eligible children. Adult dental coverage is a state option, which is why it varies so sharply. Maine operates a comprehensive adult dental benefit for adults aged 21 and over. In the state's own words: "Beginning July 1, 2022, we will expand adult dental coverage. All MaineCare members over age 21 years old will have access to comprehensive dental coverage." Confirm your own category before booking, because Maine eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Record the event date and the decision deadline for the Maine issue.
- Select Maine in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Capture the operative rule, not merely a search-result snippet.
- Use Find a Provider if interpretation or application remains uncertain.
Red flags
- An authority link that does not identify Maine or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
For “What should I confirm before booking Medicaid dental care in Maine?,” In Maine, verify the rule or credential through Medicaid.gov’s Maine profile and the current Maine Medicaid dental program materials before comparing providers or acting. A provider-facing checklist should test child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. The provider CTA is the next step, not a substitute for verifying the governing source.
Quick checklist
- Identify the person, service, and jurisdiction involved in Maine.
- Select Maine in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Maine-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- An authority link that does not identify Maine or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
For “How do prior authorization and managed-care rules affect Maine dental access?,” The defensible starting point in Maine is Medicaid.gov’s Maine profile and the current Maine Medicaid dental program materials, not an undated national summary. Then confirm child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. Do not rely on the summary alone; verify first, then use Find a Provider.
Quick checklist
- Name the exact Maine decision and the date that could change it.
- Select Maine in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Save the source URL, page title, and review date in your notes.
- Compare provider scope and written terms before using Find a Provider.
Red flags
- A generic fifty-state chart replacing Maine primary material
- No license or designation verification
- Pressure to act before written terms are supplied
For “When should I use Find a Provider for Medicaid dental care in Maine?,” The controlling verification path for Maine runs through Medicaid.gov’s Maine profile and the current Maine Medicaid dental program materials; screenshots and blog charts are secondary. Use the source to separate general guidance from child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. Use Find a Provider only after the authority check so the next conversation starts with the right questions.
Quick checklist
- Identify the person, service, and jurisdiction involved in Maine.
- Select Maine in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Maine-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- An authority link that does not identify Maine or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
Need help applying this guide?
- Louisiana Medicaid Dental Coverage Guide
- Maryland Medicaid Dental Coverage Guide
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- Maine Dental Insurance Marketplace Guide
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- TRT Legality and Prescribing Rules in Maine
- USCIS Civil Surgeons in Maine