Critical Access Hospitals and Nursing Facilities Rate Updates, CR 119227 and 119226

Aug 04, 2023

Effective July 1, 2023, the Critical Access Hospital (CAH) swing bed rate and Nursing Facility (NF) days awaiting placement rates have been recalculated for SFY 2024. You can view both related memos on the secure Health PAS online portal. 

New rates can be billed for services delivered on or after July 1, 2023, through June 30, 2024: 

• For CAHs for swing bed days, the new rate is $339.46 per day.  

• For NFs for days awaiting placement, the new rate is $121.37 per day. 

To receive the updated rate for paid claims with dates of service July 1, 2023 or after, that were submitted prior to the implementation date of August 9, 2023:  

• Providers must adjust all paid claims that were billed below the new rates. 

• MaineCare will adjust paid claims that were billed at or above the new rates. 

Please contact your Provider Relations Specialist with questions: Bruce Cosgrove for NFs, and Tiffany Norton for hospitals.