Prior Authorization (PA) Requests for Dentures

Dec 09, 2024

PA requests for complete dentures must include ALL of the following:

• The MaineCare Removeable Prosthodontics PA Form, found on the Health PAS Online Portal
• A treatment plan, completed by providers within their scope of service
• A radiographic or photographic image(s)

We will defer PA requests that do not include appropriate documentation and send a letter to the provider. 

If the member is edentulous, the request may only include the MaineCare Removeable Prosthodontics PA form attesting to this. Treatment plans and radiographs are not required in these instances.

For questions regarding PAs for dentures, please reach out to Shannon Beggs Provider Relations Specialist.