Co-pay Update: Section 12, Consumer Directed Attendant Services - Rate Update for Personal Care Services Sections 12, 19, & 96, CR 93864

Co-pay Update: Section 12, Consumer Directed Attendant Services

As a follow up to the COVID-19 Public Health Emergency Services emergency rule, MaineCare will also be waiving co-payments for members who receive services through Section 12, Consumer Directed Attendant Services, during the COVID-19 public health emergency. The waiving of copays for Section 12 is effective March 18, 2020. 

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Rate Update for Personal Care Services Sections 12, 19, & 96, CR 93864

 

As announced on March 30, 2020, the Department will be increasing rates to support pay raises for personal care workers, including personal support specialists, home health aides, private duty nurses, and other professionals who care for Maine's older  and disabled residents at home.

 

These increases will be effective April 1, 2020, rather than July 1, 2020 as initially planned, to help support those who have been impacted by the COVID-19 public health emergency. Effective April 1, 2020, the new rates for Personal Care Services are updated in MIHMS.  Please see the list of affected codes below: 

 

Facility/Provider/Procedure Code Title/Program Name	Revenue Code	Procedure Code	Modifier	Rates Effective 4/1/2020
Section 96, Private Duty Nursing	0571	T1004		$7.06
	0571	T1004	UN	$3.88
	0571	T1004	UP	$2.82
		S5125		$4.86
		S5125	UN	$2.67
		S5125	UP	$1.94
		S5125	TF	$26.60
		S5125	TF UN	$14.63
		S5125	TF UP	$10.64
	0589	S5125	TF	$26.60
	0589	S5125	TF UN	$14.63
	0589	S5125	TF UP	$10.64
		T1019		$6.55
		T1019	UN	$3.60
		T1019	UP	$2.62
	0589	T1019		$6.55
Section 12, Consumer Directed Attendant Services		S5125	U2	$4.86
		S5125	U2 UN	$2.67
		S5125	U2 UP	$1.94
Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities		G0156	U7 TF	$28.43
	0571	G0156	U7 TF UN	$15.64
	0571	G0156	U7 TF UP	$11.37
		S5125	U7	$4.86
		S5125	U7 UN	$2.67
		S5125	U7 UP	$1.94
	0581	T1004	U7	$7.06
	0581	T1004	U7 UN	$3.88
	0581	T1004	U7 UP	$2.82
		G0156	U7	$7.06
		G0156	U7 UN	$3.88
		G0156	U7	$2.82
		T1005	U7	$4.86
	0669	T1005	U7 UN	$3.88
	0669	T1005	U7 UP	$2.82
	0589	T1019	U7	$6.55
	0589	T1019	U7 UN	$3.60
	0589	T1019	U7 UP	$2.62
Section 19 Fiscal Agent Rate		T1005	U7 UN	$2.67
		T1005	U7 UP	$1.94
		T1005	U7	$6.55
Section 19 PCA Rate		T1005	U7 UN	$3.60
		T1005	U7 UP	$2.62
	0669	T1005	U7	$7.06