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Appendix G - MaineCare Reimbursement for Interpreters and MaineCare Code of Ethics for Interpreters


10-144 Chapter 101
MaineCare Benefits Manual
Chapter I
Section1 General Administrative Policies And Procedures Established: 7/1/79
Last Updated: 2/2/06

1.06 Covered And Non-Covered Services
1.06-3 Interpreter Services

i. Providers must ensure that MaineCare members are able to communicate effectively with them regarding their medical needs. MaineCare will reimburse providers for interpreters required for limited and non-English speaking members and/or deaf/hard of hearing members, when these services are necessary to communicate effectively with members regarding health needs. Interpreter services can only be covered in conjunction with another covered MaineCare service. Interpreter wait time is not covered.

B. Family members or personal friends may be used as interpreters, but cannot be paid. "Family" means any of the following: husband or wife, natural or adoptive parent, child, or sibling, stepparent, stepchild, stepbrother or stepsister, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, grandparent or grandchild, spouse of grandparent or grandchild or any person sharing a common abode as part of a single family unit.

Family members or friends, with the exception of those individuals under the age of 18, may be used as non-paid interpreters if:

  1. requested by the member; and
  2. the use of this friend or family member does not compromise the effectiveness of services or violate the member’s confidentiality; and
  3. the member is advised that an interpreter is available at no charge to the member.

C. If a paid interpreter is hired, providers can select the interpreter. In addition, should the interpreter provide transportation to the member, MaineCare will not reimburse the interpreter for transporting the member while concurrently billing for interpreter services. All interpreter services must be provided in accordance with the Americans with Disabilities Act.

D. When providers request reimbursement for any interpreter services, the services must be included in the member record. Documentation must include a statement verifying the interpreter qualifications, date, time and duration of service, language used, the name of the interpreter, and the cost of performing the service.

E. Providers are responsible for ensuring that interpreters protect patient confidentiality and adhere to an interpreter code of ethics. Providers shall document that interpreters have provided evidence of having read and signed a code of ethics for interpreters equivalent to the model included as Appendix #1. This shall be deemed as compliance with this requirement.

F. Interpreter Codes

Providers must use the following code when billing for reimbursement for interpreters for both deaf/hard of hearing members, and for language interpreters required for non-English speaking members:

T1013 Sign language or oral interpreter services per fifteen minutes.

G. Interpreters for Deaf/Hard of Hearing Member

Providers of interpreter services must be licensed by the Maine Department of Professional and Financial Regulation as: Certified Interpreters/Transliterators, Certified Deaf Interpreters, Limited Interpreters/Transliterators, or as Limited Deaf Interpreters.

MaineCare will pay for two interpreters for deaf MaineCare members who utilize non-standard signing and request a relay interpreting team including a deaf interpreter, for whom signing is in his/her native language, working with a hearing interpreter.

Note: Any other codes for interpreter services for deaf/hard of hearing members currently listed in the specific service sections of the MaineCare Benefits Manual are no longer valid.

H. Language Interpreters

Providers may obtain language interpreter services either through local resources, national language interpreter services such as the “Pacific Interpreters, Language Line,” or comparable services. Wherever feasible, local and more cost effective interpreter resources are to be used.

In all cases, the provider must include in the member’s record the date and time of the interpreter service, duration, language used, and the name of the interpreter. For language interpreters required for non-English speaking members, providers must use:

ZA7* Interpreter services provided via documented use of Pacific Interpreters, Language Line, or equivalent telephone interpreting service, must be by report with copies of the invoice attached.

*Please Note: This code is subject to change and may be superseded by any appropriate code(s) released as part of the Healthcare Common Procedure Coding System (HCPCS).

I. Exceptions

Hospitals, private non-medical institutions, intermediate care facilities for people with mental retardation, and nursing facilities may not bill separately for either language or deaf/hard of hearing interpreter services. For hospitals, private non-medical institutions, ICF-MRs, and nursing facilities, these costs will be allowable and are included in the calculation of reimbursement.

10-144 Chapter 101
MaineCare Benefits Manual
Chapter I
Section1 General Administrative Policies And Procedures Established: 7/1/79
Last Updated: 2/2/06

Appendix #1

Code Of Ethics For Interpreters*

The following principles of ethical behavior are affirmed to protect and guide interpreters and transliterators, both for non-English speaking, and for hearing and deaf members. Underlying these principles is the desire to ensure for all the right to communicate.

This Code of Ethics applies to all interpreters and transliterators providing services to MaineCare members and reimbursed by MaineCare.

  • Interpreters/transliterators shall keep all assignment-related information strictly confidential.
  • Interpreters/transliterators shall render the message faithfully, always conveying the content and spirit of the speaker using language most readily understood by the person(s) whom they serve.
  • Interpreters/transliterators shall not counsel, advise or interject personal opinions.
  • Interpreters/transliterators shall accept assignments using discretion with regard to skill, setting, and the members involved.
  • Interpreters/transliterators shall request compensation for services in a professional and judicious manner.
  • Interpreters/transliterators shall function in a manner appropriate to the situation.
  • Interpreters/transliterators shall strive to further knowledge and skills through participation in workshops, professional meetings, interaction with professional colleagues, and reading of current literature in the field.
  • Interpreters/transliterators shall strive to maintain high professional standards in compliance with the Code of Ethics.

I have read, understand and agree to abide by the Code of Ethics as stated above.

____________________________________________
printed name written signature

____________________________________________
date

* Adapted from the Code of Ethics of the Registry of Interpreters for the Deaf (RID).