Section 91, Health Home Services - Community Care Teams (CCTs) & Section 93, Opioid Health Home Services: Cost-of-Living Adjustments (COLAs) Implementation Plan
As previously noticed, MaineCare is increasing reimbursement rates for Sections 91 and 93 to reflect a 1.0% COLA.
MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to June 21, 2025, to align with the regular billing cycle for these services.
Updated fee schedules will be available by September 24, 2025, on the Rate Setting page of the Health PAS online portal.
Adjustment Billing Guidance
Section 91 CCT non-claims payments: the 1.0% payment difference for July (6/21/2025 - 7/20/2025) and August (7/21/2025 - 8/20/2025) service months’ payments will be processed and paid with the September (8/21/2025 - 9/20/2025) service month the second week of October. No action is required of CCT providers.
Section 93 claims submitted with charges at or above the new rates: MaineCare will reprocess affected claims. Providers will be responsible for adjusting claims submitted with charges below the new rates.
The Department recommends adjusting claims with the oldest dates first, to avoid 120-day adjustment timely filing edits.
For additional billing guidance when adjusting or reversing claims, please see the How to Adjust Claims for Retro Rate Increases (PDF) document.
For questions, please contact your Provider Relations Specialist.