Attention Section 90 Providers: Upcoming Changes for Billing Topical Fluoride Varnish 

Jul 22, 2022

On August 22, 2022, the Department will remove Dental Procedures and Nomenclature (CDT) code D1206, Topical Application of Fluoride Varnish, from non-dental provider contracts so that it is no longer billable by non-dental providers. This change is part of the rulemaking for MaineCare Benefits Manual, Chapter II, Section 90, Physician Services, which was adopted on May 9, 2022.       

When D1206 is removed, providers billing for the application of topical fluoride varnish under Section 90 should bill using the existing Current Procedural Terminology (CPT) code 99188 (application of topical fluoride varnish by a physician or other qualified health professional), which will be reimbursed the same rate as D1206 starting August 1, 2022.   

Providers that have already billed claims containing CPT code 99188 for dates of service between July 1 and July 31, 2022, should resubmit claims using D1206 because the rate for CPT code 99188 was inadvertently reduced.    

Please contact your Provider Relations Specialist with questions.