Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 31. Maryland Insurance Administration |
Subtitle 10. HEALTH INSURANCE—GENERAL |
Chapter 31.10.45. Dental Network Adequacy |
Sec. 31.10.45.03. Travel Distance Standards
Latest version.
-
A. Sufficiency Standards.
(1) Using the zip code list on the Maryland Insurance Administrations website, each provider panel of a carrier shall have within the geographic area served by the carriers network or networks, sufficient dentists, including specialty providers, and facilities to meet the maximum travel distance standards listed in the chart under §A(2) of this regulation for each type of geographic area measured from the enrollees place of residence.
(2) Chart of Travel Distance Standards.
Urban Area
Maximum
Distance
(miles)Suburban Area
Maximum
Distance
(miles)Rural Area
Maximum
Distance
(miles)Provider type: General dentist 15 30 60 Endodontic 30 45 75 Orthodontics and dentofacial orthopedics 30 45 75 Oral and maxillofacial pathology 30 45 75 Oral and maxillofacial radiology 30 45 75 Oral and maxillofacial surgery 30 45 75 Pediatric dentistry 30 45 75 Periodontic 30 45 75 Prosthodontics 30 45 75 B. Each provider panel of a carrier shall include at least 20 percent of the available essential community providers who provide dental services in each of the urban, rural, and suburban areas.