Section 101, Medical Imaging Services Revised Rates Effective January 1, 2025, CR 129496
Effective January 1, 2025, we implemented new rates for Section 101, Medical Imaging Services.
Statewide Marketing of Adult Day Services
The Office of Aging and Disability Services (OADS) is excited to announce a statewide marketing effort to increase awareness of Adult Day Services.
The marketing plan includes digital, broadcast and cable television, and streaming segments as well as a refresh to the OADS Adult Day Services webpage.
Section 97, Private Non-Medical Institutions, (PNMI) Appendix E - Clinical Documentation for Continued Stay Reviews
As of May 1, 2025, providers of Section 97 appendix E (PNMI E) must submit clinical documentation supporting medical necessity.
Providers must submit this clinical documentation into the Atrezzo system every 90 days as part of each member’s continued stay review. The documentation must include all of the following:
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The member’s diagnosis
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Level of care utilization system (LOCUS) score
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Treatment plan
Inside the Enhanced ‘By the Numbers’ Dashboard: Greater Insights for Maine DHHS
Mar 3, 2025
Maine’s Department of Health and Human Services (DHHS) is committed to providing clear, accurate, and transparent data about its programs and services. As part of this commitment, Maine DHHS recently launched an updated “By the Numbers” data dashboard.
Updated Billing Guidance for Section 28 Providers
This notice clarifies and updates the Department's guidance on December 31, 2024.
Providers of Specialized Services cannot bill for any time a Board-Certified Behavior Analyst (BCBA) spends delivering services, including, but not limited to, the BCBA Services outlined in MaineCare Benefits Manual (MBM) Section 28.04-3.
Quarter 1, 2025, Section 90 - Physician Drug Rates, CR 129556
Effective January 1, 2025, MaineCare retroactively updated the Physician Drug Rates to align with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate update. We implemented these rates on February 19, 2025.
2025 Indian Health Services (IHS) Rate Update, CR 129495
Effective January 1, 2025, the rate for IHS providers increased to $801.00. We implemented this new rate on February 5, 2025.
The Department will reprocess affected claims. No provider action is required.
Please contact your Provider Relations Specialist with questions.
REVISED Section 90, Primary Care Provider (PCP) Rates Effective January 1, 2025, CR 129557
Effective January 1, 2025, MaineCare updated the PCP rates under Section 90 to align with the Centers for Medicare & Medicaid Services’ (CMS) revision of rates. on February 19, 2025. The updated rates can be found on the Health PAS Online Portal.
Attention Providers: Update on Capping of MaineCare Payment Cycles
On February 10, 2025, we shared that, if the Legislature does not pass the Fiscal Year 2025 supplemental budget request to fill the MaineCare shortfall, the Department will not have sufficient funds to pay MaineCare providers in full through the end of the fiscal year and will need to temporarily withhold
Seasonal Influenza Activity Remains Elevated in Maine
It's not too late to vaccinate, take steps to prevent illness
AUGUSTA-- Influenza (flu) activity remains high across Maine with hospitals admitting over 900 individuals so far this season. The Maine Center for Disease Control and Prevention (Maine CDC) encourages everyone to take steps to protect themselves and others from getting sick.