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-20 - Allowances for Home and Community Based Services for Adults with Other Related Conditions
|
PROC CODE |
MODIFIER |
DESCRIPTION |
UNIT |
MAXIMUM ALLOWANCE |
||
|
T1016 |
U8 |
Care Coordination (Case Management) |
1/4 hour |
$17.00 |
||
|
T2021 |
U8 |
Community Support (Day Habilitation) |
1/4 hour |
$5.33* |
||
|
T2016 |
U8 |
Home Support (Residential Habilitation) |
Per Diem |
$287.91* |
||
|
T2017 |
U8 |
Home Support (Residential Habilitation) |
1/4 hour |
$6.39* |
||
|
T2017 |
U8 QC |
Home Support (Residential Habilitation)-Remote Support-Monitor Only |
1/4 hour |
$1.63* |
||
|
T2017 |
U8 GT |
Home Support (Residential Habilitation)-Remote Support-Interactive Support |
1/4 hour |
$6.39* |
||
|
T1019 |
U8 |
Personal Care |
1/4 hour |
$ 3.78* |
||
|
H2023 |
U8 |
Work Support (Supported Employment) |
1/4 hour |
$ 6.91 |
||
|
T2019 |
U8 |
Employment Specialist Services (Habilitation-Supported Employment) |
1/4 hour |
$7.49* |
||
|
97755 |
U8 |
Assistive Technology-Assessment |
1/4 hour |
$16.04 |
||
|
T2035 |
U8 |
Assistive Technology-Transmission (Utility Services) |
Month |
Up to $50.00 per month |
||
|
A9279 |
U8 |
Assistive Technology-(Monitoring feature/device, stand alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified) |
Upto $6,000.00 annually |
|||
|
V5274 |
U8 |
Communication Aids |
Per invoice |
|||
|
G9007 |
U8 GN |
Consultation -Speech |
1/4 hour |
$5.40 |
||
|
G9007 |
U8 GO |
Consultation -Occupational Therapy |
1/4 hour |
$5.40 |
||
|
G9007 |
U8 GP |
Consultation -Physical Therapy |
1/4 hour |
$5.40 |
||
|
H0031 |
U8 |
Consultation -Psychological (Psychologist, Psychological Examiner) |
1/4 hour |
$19.80 |
||
|
G9007 |
U8 HI |
Consultation -Behavioral (LCSW, LCPC) |
1/4 hour |
$13.50 |
||
|
S5165 |
U8 |
Home Accessibility Adaptations (Home Modifications) |
Per invoice |
|||
|
S5165 |
U8 CG |
Home Accessibility Adaptations (Home Modifications)-Repairs |
Per invoice |
|||
|
T2029 |
U8 |
Specialized Medical Equipment |
Per invoice |
|||
|
S8990 |
U8 GO |
Maintenance-Occupational Therapy |
1/4 hour |
$9.54 |
||
|
S8990 |
U8 GN |
Maintenance-Speech Therapy |
1/4 hour |
$12.48 |
||
|
S8990 |
U8 GP |
Maintenance-Physical Therapy |
1/4 hour |
$9.72 |
||
|
92507 |
U8 |
Non-Traditional Communication-Assessment (Treatment of speech, language, voice, communication, and or auditory processing disorder; individual) |
1/4 hour |
$9.00 |
||
|
G9007 |
U8 |
Non-Traditional Communication-Consultation |
1/4 hour |
$9.00 |
||
|
T2015 |
U8 |
Career Planning (Habilitation, prevocational) |
Per Hour |
$28.00** |
||
|
Table for Modifiers |
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|
GT |
Remote Support-Interactive Support |
|||
|
QC |
Remote Support-Monitor Only |
|||
|
GN |
Speech Therapy Services |
|||
|
GO |
Occupational Therapy Services |
|||
|
GP |
Physical Therapy Services |
|||
|
HI |
Behavioral Services |
|||
|
CG |
Repairs |
|||
|
U8 |
All Section 20 Services |
|||
* The effective date of this rate change is retroactive to April 15, 2016.
** The effective date of this rate change is March 1, 2017
