MaineCare Cost of Living/Part AAAA Increases for Sections 12, 18, 19, 20, 21, 29, 65 (SUD-IOP only), and 96

Jan 10, 2023

MaineCare has increased reimbursement rates for MaineCare Benefits Manual, Chapter III, Sections 12, 18, 19, 20, 21, 29, 65 (Substance Use Disorder Intensive Out-Patient only), and 96 for services that are associated with Part AAAA of P.L. 2021, ch.398, retroactively to January 1, 2023. Providers may submit claims for the new rates and adjust any previously submitted claims to the higher rate. Please adjust your claims within 120 days of this notice.  

Please see the relevant fee schedules for the new rates on the Codes and Rates webpage.  

Prior Authorization (PA) details: 

Effective January 6, 2023, the Department has updated all prior authorizations that require pricing for sections: 12, 18, 19, 20, 21, 29, 65 (SUD – Intensive Outpatient only) and 96.  

For more details about these rate changes, please see the e-message from December 2, 2022. 

For details on Section 65 rate updates other than SUD – Intensive Outpatient, please see yesterday’s notice.  

Please contact your Provider Relations Specialist with questions at 1-866-690-5585.