Attention Section 25 Dental Service Providers Billing D4341 Periodontal Scaling and Root Planning - Hospice Services Fee Schedule Update - Section 90 Rate Updates

Attention Section 25 Dental Service Providers Billing D4341 Periodontal Scaling and Root Planning

For the remainder of the Public Health Emergency (PHE), MaineCare will no longer require providers to submit a Prior Authorization (PA) form when billing CDT code D4341. Please contact Provider Relations Specialist, Rebecca Maranda, if you have any questions.

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Hospice Services Fee Schedule Update, CR 97218

Effective October 1, 2020, the Hospice Services Fee Schedule has been updated in MIHMS. See the list below for affected codes and rates.

Section 43 - Hospice Services Fee Schedule
Updated for October 1, 2020 - September 30, 2021
Procedure Code	Description	Cumberland Rate	Androscoggin Rate	Penobscot Rate	Sagadahoc Rate	York Rate	Rural Rate*
T2042	Routine Home Care (per diem) 1-60 days	$251.99	$223.90	$245.77	$251.99	$251.99	$219.03
T2042	Routine Home Care (per diem) 61+ days	$199.17	$176.97	$194.25	$199.17	$199.17	$173.11
T2043	Continuous Home Care (hourly)	$61.31	$54.47	$59.81	$61.31	$61.31	$53.29
T2044	Inpatient Respite Care (per diem)	$495.63	$451.86	$485.94	$495.63	$495.63	$444.27
T2045	General Inpatient Care (per diem)	$1,071.83	$960.32	$1,047.13	$1,071.83	$1,071.83	$940.98
G0299	Service Intensity Add-On (Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes)	$15.33	$13.62	$14.96	$15.33	$15.33	$13.32
G0155	Service Intensity Add-On (Services of a clinical social worker in the home health or hospice setting, each 15 minutes)	$15.33	$13.62	$14.96	$15.33	$15.33	$13.32
	Physician Services (non-hospice services)	Fee for Service - Section 90
	* Rural Maine - All other counties

You can also find the spreadsheet on the Codes and Rates webpage. Please use the new rates beginning on October 1^st. Please contact your provider relations specialist, Tammy Usher by email at Tammy.L.Usher@maine.gov or phone at (207) 624-6933.

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Section 90 Rate Updates, CR 96041

Some rates for Sections 90 have been updated in MIHMS and are now available for viewing on the Health PAS Online Portal. See the Section 90 Rate Update spreadsheet for a list of codes with new rates, when the rates were updated in MIHMS, the effective dates, , and end dates, when appropriate.

We will reprocess claims that paid at the incorrect rates, so no provider action is needed.

Please contact your provider relations specialist with questions.