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Home > Provider > Provider Enrollment > Provider Type/ Specialty/ Subspecialty Sheets

Provider Type/Specialty/Subspecialty Sheets (Listing by Category and Specialty)

Ambulatory Health Care Facilities and Clinics (.pdf)
Ambulatory Surgical Center
- Chapter II & III Section 4
Family Planning Agency
- Chapter II & III Section 30
Ambulatory Care Clinic
- Chapter II & III Section 3
Rural Health Center
- Chapter II & III Section 103
VD Screening
- Chapter II & III Section 150
FQHC
- Chapter II & III Section 31
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Behavioral Health Services (.pdf)
Mental Health Agency
- Chapter II & III Section 65
Psychologist
- Chapter II & III Section 65
Psych Examiner
- Chapter II & III Section 65
Substance Abuse Services
- Chapter II & III Section 65
Home Based Mental Health
- Chapter II & III Section 37
Developmental & Behavioral Clinics
- Chapter II & III Section 23
Community Support
- Chapter II & III Section 17
LCSW
- Chapter II & III Section 65
LCPC
- Chapter II & III Section 65
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Behavioral and Developmental Services MR Bureau (.pdf)
Case Management
- Chapter II & III Section 13
MR Waiver
- Chapter II & III Section 21
Speech and Hearing Agency
- Chapter II & III Section 109
Physical Therapist
- Chapter II & III Section 85
Occupational Therapist
- Chapter II & III Section 60
Psychologist
- Chapter II & III Section 65
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Case Management (.pdf)
All specialities for this Provider Type use - Chapter II & III Section 13
Adults w/Mental Retardation
Persons w/HIV
Infants& Children - 0-5 with or at risk
Families of Children Who are Abused or Neglected
Children & Young Adults Who are in Care or Custody
Adults in Need of Protective Services
Children & Adolescents w/Emotional Disturbance
Children & Adolescents w/ Serious Emotional Disturbance
Juveniles Referred or Under Supervision of Juvenile
Pregnant and/or Postpartum Women and/or Those Adults with Long Term Care Needs
Residents of Kennebec, Knox, Somerset, Androscoggin
Residents of Franklin, Oxford, Androscoggin
Persons with Psychiatric Substance Dependency
Children & Adolescents Exhibiting High Risk Behaviors
Families of Children Participating in Healthy Families Benefit
Disease Case Management (Asthsma, Diabetes)
Interpreter Services
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Chiropractic Services (.pdf)
Chiropractor
- Chapter II & III Section 15
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Dental Service Providers (.pdf)
All specialities for this Provider Type use - Chapter II & III Section 25
Dentist
Denturist
Dental Hygiene School
Public Health Supervision Status
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Education Related Services (.pdf)
Early Intervention
- Chapter II & III Section 27
Day Treatment - Cert. Seed
- Chapter II & III Section 41
School Based Rehab- Cert. Seed
- Chapter II & III Section 104
School Based Fee for Service
- Chapter II & III Section 104
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Eye & Vision Services (.pdf)
Optometrist
- Chapter II & III Section 75
Optician
- Chapter II & III Section 70
Optical Lab (sole source)
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Home Care Services (.pdf)
Home Health Agency
- Chapter II & III Section 40
Hospice
- Chapter II & III Section 43
Consumer Direct Pd Att. Services
- Chapter II & III Section 10
Private Duty Nursing and Personal Care Services
- Chapter II & III Section 96
Adult PDN Services - Agency
- Chapter II & III Section 96
Adult PDN Services - Personal Care
- Chapter II & III Section 96
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Hospitals (.pdf)
All specialities for this Provider Type use -Chapter II & III Section 45
General Inpatient
General Outpatient
Physician
Dentist
Pharmacy
Ambulance
Distinct Part Unit
Swing Beds
Indian Health Services (.pdf)
Indian Health Services
- Chapter II & III Section 3
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Laboratory Services (.pdf)
Independent Laboratory
- Chapter II & III Section 55
Molecular Screening/Genetic Testing
- Chapter II & III Section 62
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Managed Care Organizations (.pdf)
All specialities for this Provider Type use - Chapter II & III Section 34
MECAPS - HMO
Voluntary MCO
Mandatory MCO
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Medical Imaging (.pdf)
Medical Imaging Services
- Chapter II & III Section 101
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Medicare Cross Over (.doc)
No policy applicable for Quimby (QMB) providers.
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Non-MaineCare Vendors (.pdf)
Social Services
- Chapter II & III Section 65
Child Health
Optional EPSDT
- Chapter II & III Section 2
OAMHS
OCFS
OES
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Nursing & Custodial Care & Residential Treatment (.pdf)
Nursing Facility
- Chapter II & III Section 67
Private Non Medical Institute
- Chapter II & III Section 97
ICF/MR
- Chapter II & III Section 50
Adult Family Care
- Chapter II & III Section 2
Redirect Room & Board
Flat Rate BH
Respite Care
Back to MaineCare Enrollment
Pharmacy/DME/Supplies (.pdf)
Pharmacy
- Chapter II & III Section 80
DME/Supplies
- Chapter II & III Section 60
Prosthetics/Orthotics
- Chapter II & III Section 60
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Physicians/Assistants/Nursing (.pdf)
Physicians
- Chapter II & III Section 90
Audiology
- Chapter II & III Section 10
Nurse Midwife
- Chapter II & III Section 14
Nurse Practitioner
- Chapter II & III Section 14
Locum Tenens - Servicing Only
Physicians Asst. - Servicing Only
Certified Nurse Anesthetist
- Chaper II & III Section 14
Certified Clinical Nurse Specialist
- Chapter II & III Section 14
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Podiatry (.pdf)
Podiatrist
- Chapter II & III -Section 95
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Private Psychiatric Hospitals (.pdf)
Private Psychiatric Hospitals
- Chapter II & III Section 45
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Rehabilitative & Restorative Services (.pdf)
Physical Therapy
- Chapter II & III Section 85
Occupational Therapy
- Chapter II & III Section 68
Freestanding Day Hab
- Chapter II & III Section 24
Day Health Services
- Chapter II & III Section 26
Rehabilitaton Services
- Chapter II & III Section 102
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Speech, Language & Hearing Services (.pdf)
Speech & Hearing Agency
- Chapter II & III Section 109
Hearing Aid Dealer
- Chapter II & III Section 109
Audiology
- Chapter II & III Section 109
Speech Language Pathology
- Chapter II & III Section 109
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State Psychiatric Hospitals (.pdf)
State Psychiatric Hospitals
- Chapter II & III Section 45
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Transportation/Ambulance (.pdf)
Full Service Transportation
- Chapter II & III Section 113
Ambulance
- Chapter II & III Section 5
Wheelchair Van
- Chapter II & III Section 113
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Waiver (.pdf)
Physically Disabled
- Chapter II & III Section 22
MR Waiver
- Chapter II & III Section 21
Elderly
- Chapter II & III Section 19
Adults w/Disabilities
- Chapter II & III Section 18
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