2026 Medicare Rates Implemented for Sections 15, 65, 75, 95, & 101
Effective January 1, 2026, MaineCare updated reimbursement rates aligned with Medicare in Sections 15, 65, 75, 95, and 101. These new rates reflect 72.4% of the current Medicare rates. Updated fee schedules are available on the Rate Setting page of the Health PAS Online Portal.
Adjustment Guidance for Dates of Service January 1, 2026 – February 3, 2026
MaineCare will adjust paid claims that were submitted with charges at or above the new rates.
Providers are responsible for adjusting claims submitted with charges below the new rates. Per policy, and to avoid timely filing denials, adjustments must be submitted within 120 days of the original claim payment date.
For questions, please contact your Provider Relations Specialist.