Use the Right Procedure Code List

June 30, 2011

There are two procedure code lists for MaineCare claims: one for claims on or before 8/31/2010 (MeCMS claims), and one for claims after 9/1/2010 (MIHMS Claims). For accurate information about coverage, prior authorizations, and rates, make sure you use the appropriate list.

  • For claims with dates of service 8/31/2010 and earlier, use the Procedure Code Look Up on the MaineCare website.

  • For claims with dates of service 9/1/2010 and later, use the MIHMS Fee Schedule. The MIHMS Fee Schedule does not include codes and rates that are in MaineCare policy Chapter III. A list of Chapter III sections and hyperlinks is included with the MIHMS Fee Schedule; see MaineCare Rates by Policy Section.

If you have questions about codes and billing, contact Provider Services at 1-866-690-5585.