Updated Payment Rates and Prior Authorization (PA) Details for Long-Term Services and Supports and Home and Community-Based Service Providers

May 04, 2022

Updated Payment Rates and Prior Authorization (PA) Details for Long-Term Services and Supports and Home and Community-Based Service Providers

On May 3, 2022, we updated the rates for MaineCare Benefits Manual, Chapter II, Sections 12, 18, 19, 20, 21, 29, and 96 that are associated with Part AAAA of P.L 2021, ch. 398, retroactively to January 1, 2022. These claims are available for providers to adjust to the higher rate. Please adjust your claims within 120 days of this notice.

Please see the relevant fee schedules for the new rates.

Prior Authorization (PA) details:

Effective May 4, 2022, the Department has updated PAs for sections 12, 18, 19, 20, 21, 29, and 96 services.

PAs for Section 21 Home Support- Agency Per Diem (T2016 or T2016 SC) will be updated and claims will be available for provider adjustment starting on Friday, May 20, 2022. These Agency Home Support codes take longer to update due to additional system changes needed to enable retroactive billing of those rates. We will notify you when those changes are complete.

For more details about these rate changes, please see the message from May 2, 2022.

Please contact Provider Relations Specialist, Tammy Usher with questions.