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-30 - Family Planning Agency Services
Subsection 144-101-II-30.07 - REIMBURSEMENT

Universal Citation: 10 ME Code Rules § 144-101-II-30.07

Current through 2024-38, September 18, 2024

A. The maximum amount of payment for service rendered shall be the lowest of the following:

1. The provider's usual and customary charge.

2. The amount listed in Chapter III, Section 30, and the Department's rate setting website: www.maine.gov/dhhs/audit/rate-setting/index.shtml.

3. The lowest amount allowed by Medicare Part B when such service is covered.

B. Family planning agencies are reimbursed at the same fee for service rates as other providers of these services, including Section 90, "Physician Services", where applicable.

C. Family planning agency service providers, when furnishing covered services, shall be reimbursed for interpreter services provided to deaf/hard of hearing MaineCare members when these services are necessary to communicate effectively with the member regarding health-care needs. Refer to the MaineCare Benefits Manual Chapter I for more information on interpreter services.

D. In accordance with Chapter I of the MaineCare Benefits Manual, it is the responsibility of the provider to seek payment from any other sources that are available for payment of a rendered service prior to billing the MaineCare Program.

Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

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