Correction: Guidance for Psychiatric Hospitals Seeking Prior Authorization (PA) for Mental Health Intensive Outpatient (IOP) Services

Aug 25, 2023

On August 18, 2023, the Office of MaineCare (OMS) notified providers of IOP services regarding the upcoming requirement to submit a PA through the Atrezzo system operated by Acentra Health (formally Kepro) and adhere to the substantive standards set forth in MBM, Chapter II, Section 65, Behavioral Health Services.     

This notice contained an incorrect billed charge for S9480- Per Diem Substance Use. The chart below has been updated with the correct reimbursement amount.     

 It continues to be the Department’s preference that IOP providers enroll and bill under Section 65, however, until such a time the rules governing Psychiatric Hospital Service and reimbursement are updated, MaineCare will continue to allow billing under Section 46.      

If you have questions regarding the standards set forth in Section 65, or the billing requirements for providers enrolled under Section 46, please reach out to Provider Relations Specialist Tiffany Norton.