New Modifier for Section 65 Outpatient Services for Individuals Who are Deaf in Office Setting

Jun 22, 2026

A new modifier will be required beginning on July 1, 2026, for MaineCare Benefits Manual (MBM) Section 65 “Outpatient Services - Individual/Family Therapy – Deaf, One-to-One" and “Outpatient Diagnostic Assessment - Deaf” delivered in an office setting only.

Effective July 1, 2026, providers must bill for those services with the U5 modifier, as shown in the table below, or the claims will not pay.

Through June 30, 2026, providers must continue to bill those services with no modifier. 

Code Description	Procedure Code	Modifier Through 6/30/26	Modifier Effective 7/1/26
Outpatient Diagnostic Assessment - Deaf - Office	H2000	none	U5
Outpatient Services - Individual/Family Therapy – Deaf, One-to-One - Office	H0004	none	U5

 

Note that there will be no billing changes to “Outpatient Services - Individual/Family Therapy – Deaf, One-to-One – Community”  for community outpatient services. Providers will continue to bill in accordance with the current Section 65 fee schedule, as shown in the table below.

 

Code Description	Procedure Code	Modifier
Outpatient Diagnostic Assessment - Deaf - Community	H2000	U2
Outpatient Services - Individual/Family Therapy - Deaf - Community	H0004	U2

 

For questions, please contact your Provider Relations Specialist.