Codes

Procedure Code Look Up
Revenue Codes That Require HCPCS Codes	(.xls)
Physician Fees Effective 7/1/05, Revised 9/30/2005	(.xls)

 

Procedure Code Look Up for MaineCare Codes for Physician and Durable Medical Equipment and Supply Items/Services

Physicians, physician assistants and nurse practitioners and durable medical equipment and supply providers can now look up procedure codes for their services. This listing will provide rates as well as any special requirements for the service. The listing may also be exported to Excel.

Please note that the listing does not yet include J and G codes. It will be updated in the near future to include these codes.

In concert with this listing, the Bureau has implemented a new email address bms.referencefile@maine.gov to assist you in requesting changes to procedure codes, revenue codes, ICD9 surgical codes, and ICD9 diagnosis codes. These changes include, but are not limited to, place of service changes, coverage of a code or changes to rates.

Please do not use this email address to ask questions about denied claims or to verify data on file. You will need to continue to call the previously posted numbers for assistance.

Submitting a request does not guarantee that the change requested will be made.

Generally, these requests will be reviewed on a quarterly basis by OMS (formerly BMS) staff. The exception will be for requests made for changes to places of service. Because our former claims processing system only held 18 local places of services and MECMS has all current standard places of service, the crosswalk to the expanded places of service did not cover all scenarios.

Please include the following information in your request:

Due to the number of requests received, it is not always possible to send a personal reply. Please check the procedure code listing on a quarterly basis for changes.