Attention Providers of Sections 17, 28, and 65: Kepro/Atrezzo Prior Authorization Backdate Extension for Services Impacted by January 1st Rate Study Increases

OMS has historically allowed up to five days from the service start date to enter prior authorization (PA) information into Kepro’s Atrezzo system. To implement January 1st rate study increases for services that have new modifiers or service changes, Kepro end-dated all previous PAs/cases on February 19th.

Attention Providers of Sections 17, 28, and 65: Kepro/Atrezzo Prior Authorization Backdate Extension for Services Impacted by January 1st Rate Study Increases

OMS has historically allowed up to five days from the service start date to enter prior authorization (PA) information into Kepro’s Atrezzo system. To implement January 1st rate study increases for services that have new modifiers or service changes, Kepro end-dated all previous PAs/cases on February 19th.

Billing Guidance for Prolonged Services 

Effective January 1, 2023, MaineCare adopted additional prolonged visit codes as defined by the Centers for Medicare & Medicaid Services (CMS) and identified in the table below. NOTE: On January 1, 2021, MaineCare adopted prolonged visit code G2212 as outlined in the e-message on February 18, 2021.  

Prolonged Visit Codes Covered by MaineCare 

Code 

Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840

This is a reminder that the attending provider is required on all UB-04 and 837I claims.  Effective April 1, 2023, MaineCare will deny UB-04 and 837I claims submitted without an enrolled attending provider.

The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim/encounter. The attending provider requirement includes all claim submission methods (paper, HealthPAS Online Portal, or 837I).

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