Billing Requirement for the Emergency Services Limited Benefit Package
Emergency Services, or Defined Emergency Services (DES), is a limited benefit that covers only the medical services necessary to stabilize an emergency condition. To receive proper reimbursement, providers must mark Admission Type “1” on the UB04 claim form or the Emergency Indicator “Y” on the CMS 1500 claim form and include a qualifying emergency diagnosis code.
For questions related to billing for Emergency Services or any other Limited Benefit Package offered by MaineCare, please contact your Provider Relations Specialist.