Section 71, National Diabetes Prevention Program (NDPP) 2026 Rate Update
Effective January 1, 2026, MaineCare updated the NDPP reimbursement rate. This new rate reflects 100% of the current year Medicare rates. An updated fee schedule is available on the Rate Setting page of the Health PAS Online Portal.
Adjustment Guidance for Dates of Service January 1, 2026, through February 3, 2026
MaineCare will adjust paid claims that were submitted with charges at or above the new rates. No provider action is necessary.
Providers are responsible for adjusting claims with charges submitted below the new rates, for the same date span noted above. 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.