Updated FAQ Regarding MaineCare Guidance on Reimbursement when Restraint is Utilized in Outpatient Behavioral Health Settings, Including Schools

Apr 24, 2023

The Office of MaineCare Services has updated the Frequently Asked Questions document issued in conjunction with the e-message sent on March 6, 2023, “Notice to MaineCare Providers Regarding MaineCare Reimbursement when Restraint is Utilized in Outpatient Behavioral Health Settings, Including Schools.”  

The March 6, 2023, notice clarifies that MaineCare does not reimburse providers for time periods when a provider subjects a member to a restraint in outpatient behavioral health settings, including school settings.

The updated Frequently Asked Questions document is posted on MaineCare’s School Health-Related Services webpage. 

For questions regarding MaineCare billing, please contact your Provider Relations Specialist.

For questions specifically regarding prior authorization of services, please contact Kepro Provider Services at 866-521-0027 or ProviderRelationsME@Kepro.com.