Quarter One Physician Drug Retroactive 2025-2026 Rate Update, CR 140104
The Department updated multiple physician drug codes retroactively due to a rate update from the Centers for Medicare & Medicaid Services (CMS). These new rates were implemented on May 13, 2026.
See the table below for the revised rates and their effective dates.
|
Procedure Code |
Start Date |
End Date |
Original Rate |
Revised Rate |
|
J0588 |
10/1/2025 |
12/31/2025 |
$5.57 |
$5.30 |
|
J1939 |
10/1/2025 |
12/31/2025 |
$0.37 |
$0.54 |
|
J1939 |
1/1/2026 |
3/31/2026 |
$0.36 |
$0.51 |
|
J2270 |
10/1/2025 |
12/31/2025 |
$2.18 |
$2.46 |
|
J2270 |
1/1/2026 |
3/31/2026 |
$3.04 |
$3.26 |
|
J2777 |
1/1/2026 |
3/31/2026 |
$32.90 |
$32.87 |
|
J9055 |
1/1/2026 |
3/31/2026 |
$75.58 |
$75.72 |
|
J9308 |
1/1/2026 |
3/31/2026 |
$75.58 |
$75.72 |
|
J9332 |
4/1/2025 |
6/30/2025 |
$32.38 |
$32.24 |
|
J9332 |
7/1/2025 |
9/30/2025 |
$32.16 |
$30.32 |
|
J9332 |
10/1/2025 |
12/31/2025 |
$32.15 |
$32.10 |
|
J9334 |
4/1/2025 |
6/30/2025 |
$33.37 |
$33.33 |
|
J9334 |
7/1/2025 |
9/30/2025 |
$33.68 |
$31.76 |
|
J9334 |
10/1/2025 |
12/31/2025 |
$33.89 |
$33.87 |
|
J9358 |
7/1/2025 |
9/30/2025 |
$30.00 |
$28.30 |
Adjustment Guidance for Dates of Service April 1, 2025 through March 31, 2026
MaineCare will adjust all affected claims. No provider action is necessary.
For questions, please contact your Provider Relations Specialist.