Codes and Rates Additions or Changes

July 10, 2012

There is now a MaineCare Code and Rate Change Committee that reviews all requests for code or rate inquiries, additions, changes, and deletions in MIHMS. With the formation of the new committee, there is an email box specifically for code or rate inquiries and requests.

A HIPAA Compliant Code Requests Form must now be completed to add, change, or delete a HIPAA Compliant code in MIHMS. The form is not required for rate requests. This form will give the committee enough information to process your request.

If your code inquiry, addition, or change is related to unclassified codes or the miscellaneous supply code 99070, you will need to include the supporting documentation as an attachment with your email and the HIPAA Compliant Requests Form. Supporting documentation should include evidence of medical necessity, frequency of treatment, efficacy of treatment, and explanation of why another currently open code would not be appropriate.

If you have questions, please email the Code and Rate Change Committee.