REVISED Medicare Standardization Rates Effective March 9, 2024: Sections 15, 68, 75, 85, and 109

Apr 08, 2024

The Centers for Medicare & Medicaid Services (CMS) has revised its rates effective March 9, 2024. To align with these changes, MaineCare has been working to update reimbursement rates for Medicare covered codes and services. The new rates will reflect 72.4% of the most recent, 2024 Medicare rates.  

Rates were implemented on April 3, 2024, for all sections noted below.  

The Department has begun to post the updated fee schedules to the Rate Setting page of the Health PAS online portal and will continue to do so as they are completed.

Note that these adjustments only apply to services benchmarked to Medicare under the specified sections of policy for eligible services above. When a section of policy cross-references rates in a separate section of policy, the reimbursement provisions in the cross-referenced section of policy dictates the reimbursement amount (e.g. reimbursement for laboratory services under Section 95, Podiatry, is dictated by reimbursement methodology and rates set forth in Section 55, Laboratory Services. Podiatry providers will continue to receive reimbursement for Laboratory services in accordance with Section 55).  

Adjustment of Claims 

• The Department will reprocess claims that were submitted at or above the new rates for dates of service March 9, 2024, through the date of implementation and no provider action is required. 

• Providers who billed claims with charges below the new rates for the same date span 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.