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The goal of the EPSDT program is to ensure that individual children get the health care they need when they need it – the right care to the right child at the right time in the right setting.
What is EPSDT?
The information below is archived information about the program.
This program was formerly called the Electronic Health Records (EHR) Incentive Program.
When there are code rate updates affecting MaineCare providers, we send e-message notifications. Sign up for notifications here. Because sometimes there are many codes involved in the rate changes, the rate updates are provided below in spreadsheets. These spreadsheets do not reflect all rate and code changes. See the Provider Fee Schedules for more detail.
MaineCare covers about 50% of children and 1 in 4 Mainers. See more information about why you should enroll with MaineCare in Enrollment Rationale (PDF).
We moved the pharmacy information to a new Pharmacy Services webpage.
Visit the Health PAS Online Portal for:
MaineCare covers Non-Emergency Transportation (NET) for eligible members. You may get a ride to your MaineCare-covered appointment or have your ride reimbursed by MaineCare.
Make sure to make an appointment at least two business days in advance and check that it is covered by MaineCare and approved by the transportation broker.
MaineCare works with transportation brokers to schedule rides for our members. Call the broker in your area to ask about scheduling a ride.
MaineCare pays for medically necessary services based on your coverage group, which is determined by your income, age, medical needs, and if you need help with Activities of Daily Living (ADLs).
Effective August 1, 2022, MaineCare has extended postpartum coverage to 12 months after the pregnancy ends. This coverage is automatically applied to current MaineCare members and ensures that no one loses access to care during the postpartum period.
