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 III - Allowances for Services
Section 144-101-III-18 - Allowances for Home and Community-Based Services for Adults with Brain Injury
|
PROC CODE |
MODIFIER |
DESCRIPTION |
UNIT |
MAXIMUM ALLOWANCE |
||
|
97755 |
U9 |
Assistive Technology-Assessment |
1/4 hour |
$14.44 |
||
|
T2035 |
U9 |
Assistive Technology-Transmission (Utility Services) |
Month |
$50.00 per month |
||
|
A9279 |
U9 |
Assistive Technology-(Monitoring feature/device, stand alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified) |
Per device |
|||
|
T1016 |
U9 |
Care Coordination (Case Management) |
1/4 hour |
$ 17.00 |
||
|
T2015 |
U9 |
Career Planning (Habilitation, prevocational) |
per hour |
$ 28.00 |
||
|
97537 |
U9 |
Community/Work Reintegration-Individual |
1/4 hour |
$ 14.05 |
||
|
97537 |
U9 HQ |
Community/Work Reintegration-group |
1/4 hour |
$ 9.37 |
||
|
T2019 |
U9 |
Employment Specialist Services (Habilitation, supported employment waiver) |
1/4 hour |
$ 7.49 |
||
|
T2016 |
U9 |
Home Support (Residential Habilitation)Level II |
Per Diem |
$ 301.39 |
||
|
T2016 |
U9 TG |
Home Support (Residential Habilitation)Level III- Increased Neurobehavioral |
Per Diem |
$ 489.61 |
||
|
T2017 |
U9 |
Home Support (Residential Habilitation)Level I |
1/4 hour |
$ 6.33 |
||
|
T2017 |
U9QC |
Home Support (Residential Habilitation)-Remote Support-Monitor Only |
1/4 hour |
$ 1.63 |
||
|
T2017 |
U9 GT |
Home Support (Residential Habilitation)-Remote Support-Interactive Support |
1/4 hour |
$ 6.33 |
||
|
97535 |
U9 |
Self Care/Home Management Reintegration-Individual |
1/4 hour |
$14.52 |
||
|
97535 |
U9 HQ |
Self Care/Home Management Reintegration-Group |
1/4 hour |
$ 9.68 |
||
|
S5102 |
U9 |
Work Ordered Day Club House (Adult Day Care) |
Per Diem |
$65.00 |
||
|
H2023 |
U9 |
Work Support (Supported Employment)-Individual |
1/4 hour |
$6.91 |
||
|
MODIFIERS |
DESCRIPTIONS |
|||||
|
U9 |
Indicates Section 18 Services |
|||||
|
GT |
Remote Support-Interactive Support |
|||||
|
QC |
Remote Support-Monitor Only |
|||||
|
HQ |
Group Setting |
|||||
|
TG |
Complex/high tech level of care |
|||||
* The effective date of this rate change is retroactive to 4/15/16.
