MaineCare Bulletins

Date Title Topic
New MaineCare Coverage for Federally Non-Qualified Children Under 21 and Pregnant People  General, All Services
Updated Payment Rate Details for Substance Use Disorder (SUD) Intensive Outpatient Program (IOP) Service Providers, CR 110559  Behavioral Health (BH)
Primary Care Plus (PCPlus) Orientation Events  Dental Services
Dental Prior Authorization (PA) Forms, CR 110373  Dental Services
UPDATE for Providers Billing on UB-04 and 837I Claims, CR 107682  General Notifications for All Providers
MaineCare Benefits Manual, Chapter II, Section 25, Dental Services (repeal); Chapter III, Section 25, Allowances for Dental Services (repeal); Chapter II, Section 25, Dental Services and Reimbursement Methodology (rule replaces the two repealed rules) State & Federal Policy
MaineCare in Education: Correction to TM and TL Modifier Language for Private Duty Nursing (PDN) Medical Necessity School Health Related Services
Attention Home Health Service Providers: Tomorrow, July 1, 2022 EVV Soft Launch Implementation Long Term Services and Supports
Attention Nursing Facilities and Residential Care Facilities – Rate Letters for State Fiscal Year 2023 Long Term Care Services
MaineCare in Education: Private Duty Nursing (PDN) Medical Necessity School Health Related Services
How to Adjust Claims for Retro Rate Increase  General, All Services
Section 25 Dental Services Rulemaking Update  Dental Services
Attention Section 97, Appendix D Children’s Residential Care Facility Providers - Supplemental Payment Information  Behavioral Health (BH)
Attention Providers of Section 21 Home Support Agency Per Diem: Enforcement Discretion Related to Reimbursement for Asleep Staff  Long Term Services and Supports
Attention Home Health and Hospice Service Providers: July 1, 2022 EVV Soft Launch Implementation and MaineCare Member Letter Long Term Services and Supports
Attention Providers of Section 18, 19, 20, 21, and 29 Services: Appendix K to Maine’s Home and Community Based Waivers Continues to Provide Temporary Flexibilities on Service Caps, Staffing Long Term Services and Supports
Attention Behavioral Health Service Providers - Behavioral Health and Targeted Case Management Supplemental Payment Information  Behavioral Health (BH)
EPSDT Coverage for Children’s Residential Care Facility Level of Care Hospital & Clinic Services
EPSDT Coverage for Children’s Residential Care Facility Level of Care​ Behavioral Health (BH)
Reminder for Providers Billing on UB-04 and 837I Claims, CR 107682 General, All Services
Electronic Visit Verification (EVV) Web Browser Notice Long Term Services and Supports
CORRECTION: COVID-19 Vaccine Counseling Under the American Rescue Plan, CR 109388 – PLEASE HOLD ON SUBMITTING CODES General, All Services
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder State & Federal Policy
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder State & Federal Policy
COVID Vaccine Counseling Under the American Rescue Plan, CR 109388 Long Term Services and Supports
COVID Vaccine Counseling Under the American Rescue Plan, CR 109388  Hospital & Clinic Services
Revalidate with MaineCare to Avoid Claim Denials   General, All Services
MaineCare Cost-of-Living Adjustments (COLA) and Medicare Standardization Adjustments: Corrected Link and Fee Schedules Update  General, All Services
Update to Electronic Visit Verification (EVV) Claim Pend Process for Home Health and Hospice Services Long Term Services and Supports
Attention Providers of Sections 13, 21 and 29: Periodic Re-evaluation of Plan of Care Requirement  Long Term Services and Supports
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter III, Section 65, Behavioral Health Services State & Federal Policy
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 65, Behavioral Health Services State & Federal Policy
MaineCare Cost-of-Living Adjustments  General, All Services
Please Hold Claims for Pfizer Pediatric COVID-19 Booster Vaccine Administration Services  General, All Services
Please Hold Claims for Pfizer Pediatric COVID-19 Booster Vaccine Administration Services General, All Services
Claim Denials for No Attending Provider on UB-04 and 837I Claims Reminder, CR 107682 General, All Services
Secure Fax Number Required for Provider Enrollment Process CR 102235  General, All Services
MaineCare Updated COVID-19 Vaccine Coverage, CR 109200  General, All Services
COVID-19 Vaccine and Therapies Webinars for Clinicians  General, All Services
Enteral Nutrition and Supply Codes Have been Added to the Diabetic Supply Service Group, CR 107707 Specialty Services
Attention Hospital Providers: Alternative Settings Guidance Clarification Hospital & Clinic Services
Grant Funding Opportunity: Capital Funds for Residential Substance Use Disorder (SUD) Treatment Facilities  Behavioral Health (BH)
Attention Children’s Services Providers: COVID-19 Provider Survey  Behavioral Health (BH)
Correction to the Biosimilar Preferred Drug List  General, All Services
Correction to the Biosimilar Preferred Drug List  General, All Services
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual Chapter I, Section 1, General Administrative Policies and Procedures State & Federal Policy
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 45, Hospital Services and Chapter III, Section 45, Principles of Reimbursement for Hospital Services State & Federal Policy
Health PAS Online Portal Issues Resolved  General, All Services
Change of Edit 6075 from Deny to Warn, CR 109501 General, All Services
Attention Providers of Adult Behavioral Health Services: Updated Critical Incidents Definitions Behavioral Health (BH)