Attention Section 43 Hospice Providers: Electronic Visit Verification (EVV) Implementation Temporarily Suspended 

Mar 17, 2023

As of March 15, 2023, MaineCare temporarily excluded Hospice services from EVV requirements retroactive to January 1, 2023, as a delayed enforcement of our approved State Plan requirements. This temporary exclusion will continue until the Department can adopt final rules for Section 43, Hospice Services, which we currently anticipate will happen in the second half of 2023. This change affects hospice providers who bill codes T2042, G0299, G0155, and T2043. 

As part of the Section 43 rulemaking, the Department intends to maintain the requirement that providers submit visit records for all hospice services provided in the home. The Department intends to continue to require that claims for codes G0299, G0155, and T2043 have matching visit records as part of claims processing. Claims for code T2042 will not require a matching visit record during claims processing but may be subject to post-payment review; therefore, hospice providers should continue working toward EVV implementation. 

The Department will reprocess all hospice claims with services that denied due to a missing EVV record between January 1, 2023, and March 15, 2023. Over the next week, the Department will also release all hospice claims currently pending due to a missing EVV record so they can complete the claims processing cycle; we expect claims to pay the week after we release them, if they do not pend or deny for other reasons.   

For questions about these changes, please contact Bruce Cosgrove, Provider Relations Specialist. 

Questions about EVV implementation? 

See the EVV webpage for more information, including Frequently Asked Questions (FAQ). 

Please contact Provider Services with questions: 

• Email MaineCare's EVV email box  

• Call Provider Services at 1-866-690-5585, option 3.