Quarter 1, 2025, Section 90 - Physician Drug Rates, CR 129556
Effective January 1, 2025, MaineCare retroactively updated the Physician Drug Rates to align with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate update. We implemented these rates on February 19, 2025. The updated rates can be found on the Health PAS Online Portal.
Adjustment of Claims
The Department will adjust claims that were submitted at or above the new rates, for dates of service January 1, 2025 through February 18, 2025.
Providers are responsible for adjusting claims with charges that were submitted below the new rates, for the same date span noted above. Per policy, and to avoid timely filing denials, please submit adjustments within 120 days of the original claim payment date.
Please contact your Provider Relations Specialist with questions.
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