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Effective January 1, 2023, the Calendar Year (CY) 2023 FQHC rate letters will be accessible on the Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following this pathway: File Exchange > Reports > Rate Setting Letters.
Some Ambulatory Payment Classifications (APC) claims are overpaying when COVID-19 administration codes are billed in addition to an office visit (i.e., HCPC G0643). The COVID-19 administration code is paying 100% of APC accurately, and the office visit code is paying 100% of APC in error. MaineCare is responsible for paying 100% of APC only on the COVID-19 administration codes. We will notify you once the system is updated. No provider action is needed. Claims that overpaid incorrectly will be adjusted.
This is a reminder that the attending provider is required on all UB-04 and 837I claims. Effective April 1, 2023, MaineCare will deny UB-04 and 837I claims submitted without an enrolled attending provider.
The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim/encounter. The attending provider requirement includes all claim submission methods (paper, HealthPAS Online Portal, or 837I).
On January 1, 2023, MaineCare will add coverage for donor breast milk (CPT code T2101 - Human breast milk processing, storage, and distribution) under Section 90, Physician Services, and Section 45, Hospital Services, in accordance with Maine P.L. 2021, Ch.
The Food and Drug Administration (FDA) announced on November 30, 2022, that bebtelovimab, 175mg, no longer has Emergency Use Authorization (EAU).
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Eli Lilly EUA Monoclonal Antibody COVID-19 Infusion Treatment-bebtelovimab, 175mg |
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Correction: Application Fee for 2023 Reminder, CR 114074Please note the application fee adjustment is for CY 2023, not 2022, as published in a previous message. Electronic Visit Verification (EVV) Trainings and ForumsThe federal deadline to implement the EVV requirements for Home Health providers delivering services under Section 40 and Hospice providers delivering services under Section 43 is January 1, 2023. With these EVV deadlines quickly approaching, we continue to offer weekly provider and aggregator trainings and forums. All trainings and forums are online via Microsoft Teams. Application Fee for 2022 Reminder, CR 114074Effective January 1, 2023, in accordance with the Centers for Medicare & Medicaid Services (CMS) application fee requirements, MaineCare’s provider enrollment application fee will increase to $688 per enrollment application. This increase will apply to new, reactivating, or revalidating providers, or when adding new service locations to an existing enrollment. You can pay the application fee by credit or debit card at the time of application submission. | ||