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To align with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate update, we retroactively updated the Physician Drug Rates to October 1, 2025. These new rates were implemented for billing on November 19, 2025.
Maine CDC is adopting amendments to its Drinking Water Rule. This Rule administers the State of Maine’s drinking water requirements for approximately 1,900 public water systems for which the Department’s Maine CDC Drinking Water Program (Department), which has federal primacy.
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.
All MaineCare services delivered via Telehealth must comply with Ch I, Section 4 of the MaineCare Benefits Manual (MBM). Unless otherwise specified, all services must be billed in accordance with applicable sections of the MBM. Providers must also submit claims in accordance with Department billing instructions.
Effective January 1, 2026, MaineCare will adjust RHC rates to reflect a 1.0% COLA.
The 1.0% COLA is provided in accordance with P.L. 2025, Ch. 388, (Part GGG), which has notwithstanding language that requires the department to give this appropriated adjustment over any other COLA specified in state law.
Effective January 1, 2026, as directed by P.L. 2025 Ch. 388 Part GGG, MaineCare will adjust the NF direct care and routine rates to reflect a 1.0% COLA.
We will provide a future notice when rate letters are available.
For questions, please contact your Provider Relations Specialist.
Effective January 1, 2026, MaineCare is adjusting RCF rates to support wage increases for essential support workers. Adjustments will be made to the case-mix index portion of the direct care rate, as well as the use fixed costs from the latest cost reports.
We will provide a future notice when rate letters are available.
For questions, please contact your Provider Relations Specialist.
Effective January 1, 2026, MaineCare will increase reimbursement rates for certain services through a COLA as directed by P.L. 2025, Ch. 388 (Part GGG). This COLA is equal to an increase of 1.0% above the currently established rates.