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-65 - Behavioral Health Service
Subsection 144-101-II-65.12 - BILLING INSTRUCTIONS

A. Providers must bill in accordance with DHHS' billing requirements for the CMS 1500 claim form.

B. In order to receive full MaineCare reimbursement for claims submitted for a service that is defined as an exemption in Chapter I, Section 1, of the MaineCare Benefits Manual, providers must follow the appropriate MaineCare provider billing instructions.

C. All services provided on the same day must be submitted on the same claim form for MaineCare reimbursement.

D. For billing purposes, the unit is based on member time rather than staff time.

E. Providers must document appropriate and current ICD diagnostic codes for members receiving Medically Necessary Services in order to be reimbursed.