Provider Bulletins by Topic

Date Title Topic
Primary Care Providers (PCPlus) Quality Measure Webinar: Cervical Cancer Screening Primary Care and Care Coordination
Section 90, Physician Services Rate Update, CR 129756 Primary Care and Care Coordination
Notice of MaineCare 1115 Waiver Renewal Application, “Maine Substance Use Disorder (SUD) Care Initiative” Not in use, State & Federal Policy
Attention Primary Care Practices: Primary Care Plus (PCPlus) Program Reorientation Meeting Primary Care and Care Coordination
Attention MaineCare Providers: Status of Temporary MaineCare Payment Holds Behavioral Health (BH), Dental Services, General, All Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Not in use, Not in use, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services, State & Federal Policy
Attention Providers: Supporting MaineCare Members During Temporary Provider Payment Holds Behavioral Health (BH), Dental Services, General, All Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Not in use, Not in use, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services, State & Federal Policy
Attaching an Explanation of Benefits (EOB) to Secondary Claims General, All Services
MaineCare Rate Reform Expert Technical Advisory Panel (TAP) Consultation: Draft CY2025 Rate Determination Schedule Presented Materials and Proposed Schedule General, All Services
Revised Rates: Sections 68, 85 and 109, CRs 129558, 129513, 129352 Specialty Services
Anesthesiology Rate Updates: Section 14, Advance Practice Registered Nurses (APRNs) and Section 90, Physicians, CR 129353 Hospital & Clinic Services
Section 4, Ambulatory Surgical Center (ASC) Rates Implemented, CR 129907 Hospital & Clinic Services
Maine Center for Disease Control (CDC) Children & Youth with Special Health Care Needs Webinar Learning Series – Women, Infant & Children (WIC) 101 Behavioral Health (BH)
Attention Pharmacy Providers: Temporary MaineCare Payment Holds Retail Pharmacies
Section 21 Home Support- Agency Per Diem: Authorizations in Two-Person Homes Requirements Reminder Long Term Services and Supports
Attention Pharmacy Providers: Temporary MaineCare Payment Holds Retail Pharmacies
Attention Primary Care Practices: Primary Care Plus (PCPlus) Program Reorientation Meeting Primary Care and Care Coordination
New Hospital Services Section 45 Billing Guidance, CR 128880 Hospital & Clinic Services
​New Nursing Facility Services Section 67 Billing Guidance, CR 128953​ Long Term Care Services
Attention Providers: Temporary MaineCare Payment Holds Behavioral Health (BH), Dental Services, General, All Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Not in use, Not in use, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services, State & Federal Policy
Section 101, Medical Imaging Services Revised Rates Effective January 1, 2025, CR 129496 Specialty Services
Statewide Marketing of Adult Day Services Long Term Services and Supports
Section 97, Private Non-Medical Institutions, (PNMI) Appendix E - Clinical Documentation for Continued Stay Reviews Behavioral Health (BH), Long Term Services and Supports
Updated Billing Guidance for Section 28 Providers Behavioral Health (BH), School Health Related Services
Quarter 1, 2025, Section 90 - Physician Drug Rates, CR 129556 Primary Care and Care Coordination
2025 Indian Health Services (IHS) Rate Update, CR 129495 Primary Care and Care Coordination
REVISED Section 90, Primary Care Provider (PCP) Rates Effective January 1, 2025, CR 129557 Primary Care and Care Coordination
Attention Providers: Update on Capping of MaineCare Payment Cycles Behavioral Health (BH), Dental Services, General, All Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services
Attention Providers: AIDS Drug Assistance Program (ADAP) 101 Webinar Available General, All Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Primary Care and Care Coordination
Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840 General, All Services
MaineCare Hearing Aid Procurement Contract Coding Error Specialty Services
Prior Authorizations (PAs) for Certain Dental Services Dental Services
Attention Hospital Providers: Microdyn Update for Ambulatory Payment Classification (APC) & DRG Errors Hospital & Clinic Services
Interpreter Services – Rate Determination Kickoff Meeting General, All Services
Section 107 Psychiatric Residential Treatment Facilities (PRTF) Rate Determination - Public Comment Summary with Department Responses and Final Draft Rates Behavioral Health (BH)
Primary Care Plus (PCPlus) Quality Webinar: Lead Screening in Children Primary Care and Care Coordination
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities Not in use, State & Federal Policy
REVISED Medicare Standardization Rates Effective January 1, 2025: Sections 15, 75, & 95 - CRs 129368, 129491, 129354 Specialty Services
Section 97, Private Non-Medical Institutions, (PNMI) Appendix D, Temporary High Intensity Services Rate Determination: Presented Materials and Comment Deadline Behavioral Health (BH)
Correction to MaineCare Dental Metrics Reporting Dental Services
MaineCare Rate Reform Expert Technical Advisory Panel (TAP) Consultation on Draft CY2025 Rate Determination Schedule General, All Services
Attention Nursing Facility (NF) Administrators and Directors of Nursing: NF Quality Partnership Call Related to Quality Payment in the New NF Rate Model Long Term Care Services
Payment Error Rate Measurement (PERM) Reporting Year (RY) 2024 Errors General, All Services
Disclosures of Organizational Change Reminder General, All Services
Attention Providers: Update on FY25 Supplemental Budget Behavioral Health (BH), Dental Services, General, All Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Not in use, Not in use, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services
Attention Providers: Potential Capping of MaineCare Payment Cycles Behavioral Health (BH), Dental Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Not in use, Not in use, Not in use, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services, State & Federal Policy
340B Modifier Billing Reminder Extension – CR 129740 Hospital & Clinic Services
Residential Private Non-Medical Institution (PNMI) Appendix C Updated Rates for 2025 Long Term Care Services
Attention Providers: Potential Capping of MaineCare Payment Cycles General, All Services
Attention Providers: AIDS Drug Assistance Program (ADAP) 101 Webinar Available General, All Services
Survey for Providers of Personal Care and Home Health Services: Home and Community Based Services (HCBS) & Access Rule Long Term Services and Supports