MaineCare Cost-of-Living Adjustments (COLAs) for Sections 2, 12, 13, 17, 18, 19, 20, 21, 26, 28, 29, 60, 65, 90, 92, & 96
Effective January 1, 2026, MaineCare will increase reimbursement rates for certain services through a COLA as directed by P.L. 2025, Ch. 388 (Part GGG). This COLA is equal to an increase of 1.0% above the currently established rates.
These COLA adjustments only apply to rates specified under these sections of policy for eligible services. When a section of policy cross-references rates in a separate section of policy, the reimbursement provisions in the cross-referenced section of policy dictate the reimbursement amount. For example, services that are referenced in these policies that refer to Medicare covered reimbursement rates under Section 90 will not receive this COLA.
These COLAs affect rates for eligible services under the following sections of the MaineCare Benefits Manual (MBM):
|
MaineCare Benefits Manual Sections & Services |
|
|
2 |
Adult Family Care Services |
|
12 |
Consumer Directed Attendant Services |
|
13 |
Targeted Case Management Services |
|
17 |
Community Support Services |
|
18 |
HCBS for Adults with Brain Injury |
|
19 |
HCBS for the Elderly and Adults with Disabilities |
|
20 |
HCBS for Adults with Other Related Conditions |
|
21 |
HCBS for Members with Intellectual Disabilities or Autism Spectrum Disorder |
|
26 |
Day Health Services |
|
28 |
Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations |
|
29 |
Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder |
|
60 |
Durable Medical Equipment and Medical Supplies (Non-Medicare) |
|
65 |
Behavioral Health Services |
|
90 |
Physician Services (Non-Medicare). |
|
92 |
Behavioral Health Home Services |
|
96 |
Private Duty Nursing and Personal Care Services |
The Department will update the fee schedules for the Sections above to the Rate Setting page of the MaineCare Health PAS Online Portal as they are completed.
For questions, please contact Amanda Lee, MaineCare’s Rate Setting Coordinator.