MaineCare Benefits Manual, Section 65, Behavioral Health Services

Date posted:

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 65, Behavioral Health Services

NATURE OF PROPOSED CHANGES: The Department plans to update reimbursement for tobacco cessation counseling services for non-pregnant individuals included under Section 65 – Behavioral Health Services to align with the reimbursement methodology established in Section 90 – Physicians Services. This means, effective January 14, 2023, that the reimbursement for tobacco cessation under Section 65 will be equal to 72.4% of the Medicare Maine area 99 rate. This reimbursement will update annually consistent with Medicare updates.

REASON FOR PROPOSED CHANGES: The Department is amending reimbursement to align with recently adopted changes to Section 90 - Physician Services in order to create consistent reimbursement for like services.

ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will result in an increase of $180 in federal fiscal year 2023 which includes $114 in federal funds and $66 in state funds, and will cost $254 in federal fiscal year 2024 which includes $159 in federal funds and $95 in state funds. 

ACCESS TO PROPOSED CHANGES AND COMMENTS TO PROPOSED CHANGES:  The public may review the proposed methodology changes and written comments at any Maine DHHS office in every Maine county. To find out where the Maine DHHS offices are located, call 1-800-452-1926.


FOR RECEIPT OF COMMENTS:            Kristin Merrill  


AGENCY NAME:                                      Office of MaineCare Services

ADDRESS:                                                109 Capitol Street, 11 State House Station

                                                                    Augusta, Maine 04333-0011

TELEPHONE:                                           (207) 624-4006 FAX: (207) 287-6106

                                                                  TTY: 711 Maine Relay (Deaf or Hard of Hearing)

See for rules and related rulemaking documents.

State Plan Amendment

Office: MaineCare Services


Comment deadline:

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