REVISED Medicare Standardization Rates Effective January 1, 2025: Sections 15, 75, & 95 - CRs 129368, 129491, 129354
MaineCare made updates to Section 15, 75, and 95, Medicare covered codes and rates to align with recent revisions made by the Centers for Medicare and Medicaid Services (CMS). These new rates now reflect 72.4% of the most recent 2025 Medicare rates.
Rates were implemented on the dates listed in the table below, for the following sections:
|
Section 15 |
Chiropractic Services |
2/5/2025 |
|
Section 75 |
Vision Services |
1/22/2025 |
|
Section 95 |
Podiatry Services |
1/29/2025 |
Adjustment of Claims
The Department will reprocess claims that were submitted at or above the new rates for dates of service January 1, 2025, through the implementation date listed for the affected sections. No provider action is required.
Providers who billed claims with charges below the new rates for the same date spans above will be responsible for adjusting claims as is deemed appropriate by the provider.
For additional billing guidance, please see the How to Adjust Claims for Retro Rate Increases (PDF) document.
Please contact your Provider Relations Specialist with questions.