• Read more about Covered Services & Benefits

MaineCare pays for medically necessary services based on your coverage group, which is determined by your income, household size, age, medical needs, and if you need help with Activities of Daily Living. Each coverage group has different covered services and benefits, and there are limits or special rules for most covered services.

This page provides information about:

• Read more about Provider Resources

This webpage contains resources for service providers such as training information and videos, toolkits for communicating with patients, webinar opportunities, and information about how MaineCare communicates with providers.

Provider Training

Training Videos

Billing for Interpreter Services Training Video - This video demonstrates how to bill MaineCare appropriately for interpreter services. 

• Read more about MHBG Public Comment Form

The Community Mental Health Services Block Grant (MHBG) program's objective is to support the grantees in carrying out plans for providing comprehensive community mental health services.

• Read more about SUBG Public Comment Form

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Section 97, Private Non-Medical Institution (PNMI), Appendix C, Residential Care Facilities

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 97, Private Non-Medical Institution (PNMI), Appendix C, Residential Care Facilities (RCFs)

• Read more about Maine CDC launches immunization record mobile app

New app allows Maine people secure, instant digital access to their vaccine records

AUGUSTA-- The Maine Center for Disease Control and Prevention (Maine CDC) has partnered with a new, free, mobile application, Docket, to allow Maine people to opt in to easily, quickly, and securely access their vaccine records through their smartphones and other mobile devices.

• Read more about Code & Service Category List: HCBS Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, Assistive Technology & Personal Care Services

As part of the rate determination process the Department initiated earlier this summer for sections 12, 18, 19, 20, 21, 29, 40, 96, & 102, our vendor Public Consulting Group performed a code analysis to identify all services that will be included in this determination. 

• Read more about Dental Services

Provider Dental Forums

July 30, 2024 Dental Provider Forum  

Topics covered: 

• Services covered and underutilized   
• Claims and billing updates   
• Who to contact and when 
• Early and Periodic Screening, Diagnosis, and Treatment services (EPSDT) resources now available     
• Addressing challenges and barriers to accessing dental services  

Forum materials: 

• Read more about Notice of Rule Adoption: 10-144 CMR Chapter 269, Self-Contained Breath Alcohol Testing Equipment Rule

The Department adopted amendments to Maine’s Rules Governing Self-Contained Breath Alcohol Testing Equipment to coincide with the expiration of the current rule adopted on an emergency basis and effective on May 28, 2024. (5 MRS 8054(3)). Consistent with the proposed rule, this routine technical rule qualifies the use of a dry gas standard, ensuring that testing equipment for calibrating units under 10-144 CMR Chapter 269 remains current with industry practice for performing accuracy checks and calibration adjustments on most evidential breath alcohol testing instruments.

• Read more about Section 45, Hospital Diagnostic Related Group (DRG) and Ambulatory Payment Classification (APC) Reimbursement Changes Effective July 1, 2024

The Department notified Hospitals on July 25, 2024, of changes to DRG and APC reimbursements, effective July 1, 2024. 

MaineCare updated its claims system on August 20, 2024, to reflect these changes.