Billing Guidance for Prolonged Services
Effective January 1, 2023, MaineCare adopted additional prolonged visit codes as defined by the Centers for Medicare & Medicaid Services (CMS) and identified in the table below. NOTE: On January 1, 2021, MaineCare adopted prolonged visit code G2212 as outlined in the e-message on February 18, 2021.
Prolonged Visit Codes Covered by MaineCare |
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Code Trauma Informed Care IS Healthcare WebinarReminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840This 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). SNAP #223A - Omnibus Rule Change 2022The adoption of this final rule effectuates many changes required by state statute and federal regulation. The adopted rule aligns Maine policy with various federal waivers and options. The adopted rule makes non-substantive changes to improve the readability and inclusivity of the manual and reduces the use of stigma inducing language. Annual Report Shows Direct Support Workforce Stabilizing as Progress Continues on Long-Term Care InitiativesFeb 2, 2023 Maine is making progress in restoring access to a range of long-term support services in the wake of the COVID-19 pandemic, according to the Second Annual Report on Efforts and Progress in Implementing the Recommendations of the Commission to Study Long-term Care Workforce Issues (PDF). This new report shows actions taken in the face of the significant challenges posed by the pandemic as well as preliminary results. 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 happened January 1, 2023. We continue to offer weekly provider and aggregator trainings and forums. All trainings and forums are online via Microsoft Teams. Attention Providers of Section 65, Behavioral Health Services (Crisis Resolution/Crisis Response): Draft Service Model and Provider Survey Public MeetingMobile Crisis Response Redesign: Public Review and Provider Survey Discussion MaineCare is holding an online public meeting on February 24, 2023, to present a draft redesigned mobile crisis response service model along with the rationale for the recommended model. In addition to the presentation of the draft service model, DHHS’s rate determination vendor, Burns & Associates, will present a data collection process and survey to be completed by providers of crisis response services. Attention Providers of Sections 17, 28, and 65: Behavioral Health Rate FAQsAs mentioned in the notice on February 2, 2023, the Department now has available the Behavioral Health Rate FAQ document on billing and authorizations for services for Sections 28 and 65. Attention Providers of Sections 17, 28, and 65: Behavioral Health Rate FAQsAs mentioned in the notice on February 2, 2023, the Department now has available the Behavioral Health Rate FAQ document on billing and authorizations for services for Sections 28 and 65. | ||
