Section 45, Hospital Diagnostic Related Group (DRG) and Ambulatory Payment Classification (APC) Reimbursement Changes Effective July 1, 2024
The Department notified Hospitals on July 25, 2024, of changes to DRG and APC reimbursements, effective July 1, 2024.
MaineCare updated its claims system on August 20, 2024, to reflect these changes.
MaineCare is now adjusting all DRG and APC claims submitted between July 1, 2024, and August 20, 2024, with a ‘From Date’ of July 1, 2024, forward, retroactive to July 1, 2024. Due to the volume of claims, this adjustment process will take several weeks.
For questions, please contact Tiffany Norton, Provider Relations Specialist for Hospital Services.
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