C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-15, subsec. 144-101-II-15.06

Current through 2024-51, December 18, 2024
Subsection 144-101-II-15.06 - LIMITATIONS
A. Unless otherwise indicated in this Section, reimbursement for chiropractic services for MaineCare members ages twenty-one (21) and over shall be limited to twelve (12) visits per calendar year and based upon medical necessity. For services beyond twelve (12) visits, all eligible MaineCare members twenty-one (21) and over require prior authorization as indicated in Section 15.07-2(B).
B. Reimbursement and limitations on the number of x-rays will be based upon the criteria of medical necessity and documentation as specified in Section 15.07, Policies and Procedures.
C. When repeat x-ray examinations of the spine for the same condition are required because of technical or professional error in the original x-rays, such repeat x-rays are not a covered service and are not reimbursable by MaineCare.

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-15, subsec. 144-101-II-15.06