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A Primary Care Provider (PCP) can be a doctor, physician's assistant, or nurse practitioner, and may include other providers within a health care practice, clinic, or center. A PCP is the main health care provider responsible for managing your care.
Primary Care Plus (PCPlus) is MaineCare’s value-based approach to support primary care. PCPlus offers primary care practices greater flexibility and incentives to meet MaineCare members’ health care needs.
Health Home services include care coordination, case management, individual and family support, and health promotion/education. Each organization that is partnering to provide health home services receive a per member, per month (PMPM) payment.
Participation in any of the four health home programs, Community Care Teams (CCT), Behavioral Health Homes (BHH), MaineMOM, and Opioid Health Homes (OHH), is voluntary, and members can opt out of the service at any time.
Accountable Communities (AC) are an important component of MaineCare's Value-Based Purchasing strategy, a multi-pronged initiative aimed at reducing costs while improving quality and outcomes for MaineCare members. Similar to Medicare's Accountable Care Organizations (ACOs), MaineCare's AC program contracts with groups of providers who volunteer to participate in the shared risk savings model.
The Maine Department of Health and Human Services (DHHS) and the Office of MaineCare Services (OMS) are committed to improving health care access and health outcomes for MaineCare members, demonstrating cost-effective use of resources, and creating an environment where providers can innovate and collaborate in delivering high-quality care.
This webpage provides information and important updates about policy and billing changes to MaineCare-covered services that are provided in an educational setting.
The Office of MaineCare Services is excited to share new resources where you can learn more about how MaineCare Covered Services are delivered in Maine schools. You can access all courses using a desktop, tablet, or mobile device.
MaineCare is excited to announce the rebrand of the Early Periodic Screening Diagnosis & Treatment (EPSDT) program. The program will now be known as VitalCare for Kids!
The information below is archived information about the program.
This program was formerly called the Electronic Health Records (EHR) Incentive Program.
When there are code rate updates affecting MaineCare providers, we send e-message notifications. Sign up for notifications here. Because sometimes there are many codes involved in the rate changes, the rate updates are provided below in spreadsheets. These spreadsheets do not reflect all rate and code changes. See the Provider Fee Schedules for more detail.
MaineCare covers about 50% of children and 1 in 4 Mainers. See more information about why you should enroll with MaineCare in our Enrollment Rationale (PDF) document.