• Read more about Billing Requirement for the Emergency Services Limited Benefit Package

Emergency Services, also known as Emergency MaineCare, is a limited benefit that covers emergency medical services to stabilize the emergency condition only. For proper reimbursement, providers must use Admission Type “1” on the UB04 claim form or the Emergency Indicator “Y” on the CMS 1500 claim form.

For questions related to billing for Emergency Services or any other Limited Benefit Package offered by MaineCare, please contact your Provider Relations Specialist.

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• Read more about Microdyn Update for Ambulatory Payment Classification (APC) – CRs 137330, 137785, 137786

Effective February 21, 2026, MaineCare completed the following Centers for Medicare and Medicaid Services (CMS) quarterly updates for APCs in MIHMS.

• January 2026 Hospital Outpatient PPS | CMS 
• January 2026 Integrated Outpatient Code Editor Specs 

Claims Adjustment 

• Read more about Nursing Facility 2025 Quality Bonus Pool Payments Released

Payments for the 2025 Quality Bonus Pool will be released in the March 11, 2026 payment cycle. The Office of MaineCare Services received federal approval to release these payments on February 25, 2026. As previously noticed, payment amounts vary by facility.

• Read more about Clarification of Comment Period for Proposed Rules 10-144, C.M.R. Chapter 101, MaineCare Benefits Manuals (MBM): Chapters II and III - Section 13, Chapters II and III - Section 28, and Chapter II - Section 97

The Department issued a notice on February 25, 2026, of additional MaineCare Public Hearings for MaineCare Benefits Manuals (MBM): Chapters II and III, Section 13, 

• Read more about Clarification - Comment Period for Proposed Rules 10-144, C.M.R. Chapter 101, MaineCare Benefits Manuals (MBM): Chapters II and III - Section 13, Chapters II and III - Section 28, and Chapter II - Section 97

The Department issued notice on February 25, 2026 of additional MaineCare Public Hearings for MaineCare Benefits Manuals (MBM): Chapters II and III, Section 13, 

• Read more about Syringe Services Programs Rule; 10-144 CMR Ch. 252

The Department adopted amendments to 10-144 C.M.R. chapter 252 to incorporate Public Law 2025, chapter 408, which amended 22 M.R.S. § 1341 to explicitly permit certified Syringe Service Programs to operate mobile sites and provide delivery services in accordance with parameters set forth by Maine CDC. Rule amendments clarify that “Syringe Services” may be delivered to “Consumers” in person via “Brick and Mortar” and “Mobile” Sites, as well as hypodermic apparatus exchanges by delivery services, in accordance with 22 M.R.S.

• Read more about Billing Guidance Correction: Section 109, Speech & Hearing: 2026 Rates Implemented CR#138387

Effective January 1, 2026, MaineCare updated reimbursement rates for Section 109.  These new rates reflect 72.4% of the current Maine Medicare rates. An updated fee schedule is available on the Rate Setting page of the Health PAS Online Portal.

• Read more about ASPIRE Ruel #29 - LD 1748

The Following Rule is Adopted:

10-144 C.M.R. Chapter 607; ASPIRE-TANF Program Rule – All Sections

ASPIRE Rule #29 - LD 1748

Effective Date:

March 2, 2026

• Read more about Date Correction: Section 9, Indian Health Services (IHS) 2026 Rate Update, CR 138388

Effective January 1, 2026, the rate for IHS providers increased to $826.00. We implemented this new rate on March 4, 2026.

The Department will reprocess affected claims. No provider action is required.

For questions, please contact your Provider Relations Specialist.

• Read more about Section 109, Speech & Hearing: 2026 Rates Implemented, CR 138387

Effective January 1, 2026, MaineCare updated reimbursement rates for Section 109. These new rates reflect 72.4% of the current Maine Medicare rates. An updated fee schedule is available on the rate setting page of the Health PAS Online Portal.