Updated January 1, 2023, Behavioral Health Rate Adjustments FAQs Regarding Assertive Community Treatment (ACT)

Jan 25, 2024

Upon reassessment, the Office of MaineCare Services determined it has sufficient flexibility in policy language to require ACT providers to maintain a panel-wide average of three contacts per member, in alignment with fidelity to the model, rather than delivering a minimum monthly average for each member of three contacts per week. In accordance with MBM Section 17.04-3, in the event a member does not receive three contacts in a week, providers must continue to document why. If a member no longer requires three contacts per week because it is not clinically indicated, providers should document that in the member’s record.

Providers may bill for ACT in accordance with this guidance on dates of service beginning January 1, 2024. Providers who have already submitted claims for this period may resubmit claims. For more information, providers should view the updated January 1, 2023 Behavioral Health Rate Adjustments Frequently Asked Questions.

For questions, please contact Provider Relations Specialist, Bruce Cosgrove.