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The Department updated multiple physician drug codes retroactively due to a rate update from the Centers for Medicare & Medicaid Services (CMS). These new rates were implemented on July 30, 2025.
See the table below for the revised rates and their effective dates.
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Procedure Code |
Start Date |
End Date |
Revised Rate |
Original Rate |
Join the Office of MaineCare Services, along with Maine CDC’s Cardiovascular Health Program and HealthInfoNet to learn more about the Controlling High Blood Pressure quality measure. We will discuss measure specifications, billing practices, measure dashboards, and methods for improvement.
Webinar Date & Time: August 25, 2025, 12:00 PM – 1:00 PM
Webinar registration
Bait distribution aims to reduce the spread of the rabies virus
AUGUSTA-- In cooperation with the Maine Center for Disease Control and Prevention (Maine CDC), officials from the U.S. Department of Agriculture's (USDA) Wildlife Services will distribute oral rabies vaccine (ORV) baits in Aroostook County from August 13 through August 22. This annual late-summer ORV bait distribution is in addition to the spring distribution that occurred this year.
As previously communicated in the Department’s March 4, 2025, notice, PNMI Appendix E providers are required to submit clinical documentation supporting medical necessity every 90 days as part of each member’s CSR.
Required Documentation
Clinical documentation must be submitted through the Atrezzo system and must include the following member-specific information:
This is an update to the notice we sent on July 24, 2025,, about Health PAS Online Portal downtimes.
The portal will continue to remain down Monday through Friday from 7:00 PM to 7:00 AM and all weekend hours as Gainwell continues to address technical issues.
All errors found during a PERM audit are considered improper payments. Maine is required to reimburse the federal government for all improper payments and has the right to seek recoupment from providers for improper payments resulting from provider error.
The most common errors found in the RY 2024 PERM Audit cycle are listed below. The most common errors from the previous two PERM cycles are also included in the list. Before submitting a claim, check that the information for the member and the services provided are accurate and complete.
AUGUSTA-- The Maine Center for Disease Control and Prevention (Maine CDC) urges Maine residents and visitors to take steps to prevent rabies exposure by limiting contact with bats. Bats are most active in Maine from midsummer to early September, though bat exposures can happen at any time of year. The Maine CDC encourages people to be cautious around bats, keep a safe distance, and know what to do after exposure to a bat.
Jul 7, 2025
Medicaid provides free or low-cost health insurance and other health benefits to people who qualify based on income and household size, disability, age, and/or citizenship status. The program is jointly funded by the federal and state governments. In Maine, we call our Medicaid program "MaineCare."
July 30, 2025, marked the 60th anniversary of Medicaid, which was signed into law by President Lyndon B. Johnson in 1965. This milestone offers an opportunity to reflect on Medicaid’s key achievements and its impact on Maine over the past six decades.
Maine people and visitors urged to take precautions against tick and mosquito bites
AUGUSTA-- The Maine Center for Disease Control and Prevention (Maine CDC) announced the first human case of Powassan virus infection and the first wild bird case of West Nile virus (WNV) infection this year. An adult resident of Hancock County infected with Powassan virus developed neurologic symptoms and was hospitalized. The crow with WNV was discovered in York County.
On August 4, 2025, the Department will host a kick-off meeting to introduce the next phase of MaineCare’s PCPlus reform work, and to receive feedback on your experiences and insights from participating in the PCPlus model. This is an important step to shape the next phase of the PCPlus Alternative Payment Model (APM). This meeting was originally scheduled for July 16, 2025, but we postponed it due to technical difficulties.