2025 Drug Rate Updates for Quarters 1, 2, & 3, CR 135366
MaineCare updated multiple codes retroactively due to a rate update from the Centers for Medicare & Medicaid Services’ (CMS). The implementation date for these rates is October 15, 2025.
See the table below for the effective dates and new rates.
|
Procedure Code |
Start Date |
End Date |
Original Rate |
Revised Rate |
|
J0558 |
1/1/2025 |
|
$17.37 |
$19.52 |
|
J2597 |
1/1/2025 |
3/31/2025 |
$4.95 |
$4.87 |
|
J2597 |
4/1/2025 |
6/30/2025 |
$4.49 |
$4.39 |
|
J3300 |
4/1/2025 |
6/30/2025 |
$4.27 |
$24.52 |
|
J3300 |
7/1/2025 |
|
$24.52 |
$24.51 |
|
J7323 |
1/1/2025 |
3/31/2025 |
$120.68 |
$119.95 |
|
J7500 |
1/1/2025 |
3/31/2025 |
$1.19 |
$1.27 |
|
J7500 |
4/1/2025 |
6/30/2025 |
$1.0 |
$.94 |
|
J9155 |
1/1/2025 |
3/31/2025 |
$4.28 |
$4.34 |
|
J9304 |
7/1/2025 |
|
$52.74 |
$49.23 |
|
J9332 |
7/1/2025 |
|
$32.40 |
$32.16 |
|
J9334 |
7/1/2025 |
|
$33.74 |
$33.68 |
The Department will reprocess all affected claims for dates of service January 1, 2025, through October 14, 2025. No provider action is needed.
For questions, please contact your Provider Relations Specialist.