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-29 - Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
GENERAL PROVISIONS
Appendix 144-101-III-29-I

APPENDIX I

PROCEDURE CODE

SERVICE

MAXIMUM ALLOWANCE Effective 1/1/22

T2017

Home Support-Quarter Hour

$10.45 per 1/4 hour*

T2017 QC

Home Support-Remote Support-Monitor Only

$2.93 per 1/4 hour*

T2017 GT

Home Support-Remote Support-Interactive Support

$10.45 per 1/4 hour*

S5140

Shared Living (Foster Care, adult)-Shared Living Model-One member served

$163.71 per diem*

S5140 UN

Shared Living (Foster Care, adult)-Shared Living Model-Two members served

$122.78 per diem*

T2021

Community Support (Day Habilitation)

$6.53 per 1/4 hour

T2021 SC

Community Support (Day Habilitation)- with Medical Add On

$8.05 per 1/4 hour

T2019

Employment Specialist Services (Habilitation, Supported Employment waiver)

$14.41 per 1/4 hour*

T2019 SC

Employment Specialist Services (Habilitation, Supported Employment waiver)-with Medical Add On

$14.41 per 1/4 hour*

H2023

Work Support (Supported Employment)-Individual

$12.59 per 1/4 hour*

H2023 SC

Work Support (Supported Employment)-Individual with Medical Add On

$12.59 per 1/4 hour*

H2023 UN

Work Support (Supported Employment)-Group 2 members served

$6.23 per 1/4 hour*

H2023 UP

Work Support (supported employment)-Group 3 members served

up to $4.68 per 1/4 hour*

H2023 UQ

Work Support (supported employment)-Group 4 members served

up to $3.82 per 1/4 hour*

H2023 UR

Work Support (supported employment)-Group 5 members served

up to $3.33 per 1/4 hour*

H2023 US

Work Support (supported employment)-Group 6 members served

up to $2.98 per 1/4 hour*

T2015

Career Planning (Habilitation, prevocational)

$61.13 per hour*

S5165

Home Accessibility Adaptations

Per invoice

S5165 CG

Home Accessibility Adaptations repairs

Per invoice

97755

Assistive Technology-Assessment

$ 15.15 per 1/4 hour*

T2035

Assistive Technology-Transmission (Utility Services)

Up to $50.00 per month

A9279

Assistive Technology-Devices (Monitoring feature/device, stand alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified)

Per invoice up to $6,296.40 per year*

S5150

Respite Services- 1/4 hour

$8.63 per 1/4 hour*

S5151

Respite Services- Per Diem

$287.35 per diem*