Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter II - Specific Policies By Service
Section 144-101-II-3 - AMBULATORY CARE CLINIC SERVICES
Subsection 144-101-II-3.08 - BILLING INSTRUCTIONS
Current through 2024-38, September 18, 2024
Billing must be accomplished in accordance with the Department's "Billing Instructions for the CMS 1500 Claim Form".
MaineCare Services will replace the billing codes in Table 1, Chapter III, Section 3 with the codes found in Table 2 upon implementation of the new billing system. Providers will receive written notice thirty (30) days prior to implementation.
3.08-1 School Health Clinic Special Instructions
Each clinic must only bill using codes for sick child visits and, if applicable, all adult visits. Billing for Early and Periodic Screening Diagnosis and Treatment (EPSDT) and immunizations for well children may be billed under Chapter V of the MaineCare Benefits Manual as long as services are provided in conformance with all requirements of that Chapter, including submission of the Bright Futures form. Procedure codes for EPSDT services will be found in the Physicians' Current Procedural Terminology (CPT) manual.
