Nursing Facilities (NF): January Claims Hold and Navigating Rate Reform Billing Changes

Jan 10, 2025

Request to Hold January 2025 Claims

The Department is working to implement billing changes reflecting NF rate reform presented at the October 23, 2024 public forum and we expect these changes to be operational by February 1, 2025.

Please hold claims for services delivered in January 2025 until these changes are implemented and announced in a future notice. 

Technical Assistance Offered: Open Office Hour Sessions

Please see the Billing guidance developed to assist NFs with the change to a new case mix system (Nursing Component of the Patient Driven Payment Model, or PDPM) that was presented at the October 2024 NF Rate Reform forum. The Department will hold open office hour sessions for providers to learn more and ask questions as needed. If you utilize vendors to help with your billing, the vendors are welcome to attend office hours. See the Open Office Hour session information below.  

Thursday, January 16, 2025, 10:00 AM – 11:00 AM  

Registration Link: https://mainestate.zoom.us/meeting/register/_6pIK3p_R6SXpGyFWzwDRA

Tuesday, January 28, 2025, 11:00 AM – 12:00 PM  

Registration Link:

https://mainestate.zoom.us/meeting/register/yr7nqMvNSyu4hbuF-jpzUA

For questions, please contact your Provider Relations Specialist.