Revised Rates Effective January 1, 2026 – Sections 4, 68, 85, 95, 101, CRs 138792, 138789, 138790, & 138908

Mar 30, 2026

Effective January 1, 2026, MaineCare revised the following reimbursement rates for sections 4, 68, 85, 95, and 101, in alignment with Medicare. The new rates reflect 72.4% of the Maine Medicare rate and were implemented for billing on March 18, 2026 and March 24, 2026.

The fee schedules are updated to reflect these changes and are available on the Rate Setting page of the Health PAS Online Portal.

Adjustment Guidance

Sections 4, 68, 85, 95: Dates of Service January 1, 2026 – March 17, 2026

Section 101: Dates of Service January 1, 2026 – March 23, 2026

• Providers are responsible for adjusting claims with charges submitted below the new rates. Per policy and to avoid timely filing denials, adjustments must be submitted within 120 days of the most recent payment date. Please adjust the oldest dates of service first.
• MaineCare will adjust paid claims that were submitted with charges at or above the new rates. No provider action is necessary.

For questions, please contact your Provider Relations Specialist.