Section 25, Dental Sedation Services: Update Regarding Prior Authorization (PA) Changes Effective July 1, 2026, CR 142478
On July 1, 2026, MaineCare announced that it will no longer require providers to obtain PA for the following dental sedation Current Dental Terminology (CDT) codes:
|
CDT Code |
Definition |
|
D9222 |
Administration of deep sedation/general anesthesia – first 15-minute increment, or any portion thereof |
|
D9223 |
Administration of deep sedation/general anesthesia – each subsequent 15-minute increment, or any portion thereof |
|
D9224 |
Administration of general anesthesia with advanced airway – first 15-minute increment, or any portion thereof |
|
D9225 |
Administration of general anesthesia with advanced airway – each subsequent 15-minute increment, or any portion thereof |
On October 26, 2026, MaineCare notified providers that we were unable to implement Change Request (CR) 142478 to remove the PA for CDT code D9223 prior to the data freeze for the MIHMS upgrade.
MaineCare has implemented CR 142478 and is in the process of adjusting affected claims for dates of service on, or after, July 1, 2026.
For questions on these changes, please contact your Provider Relations Specialist.