Attention Behavioral Health Service Providers: Behavioral Health Supplemental Payment Information

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Attention Behavioral Health Service Providers - Behavioral Health Supplemental Payment Information

In response to the COVID-19 pandemic’s impact on the provision of behavioral health services, per PL 2021, ch. 1, Sec. A-16, An Act To Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Year Ending June 30, 2021, this week the Department will be issuing one-time supplemental payments to help offset lost revenue for certain behavioral health services.

Eligible services for these payments include all services provided through Sections 17 (Community Support Services) and 28 (Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations), as well as certain Section 65 (Behavioral Health Services) services: Crisis Services, Home and Community-Based Treatment, Children’s Behavioral Health Day Treatment, Clubhouse Services, and Multi-Systemic Therapy and Functional Family Therapy (MST/FFT) services. For code-level detail on the eligible services, please see the table below.  

Section 17, Community Support Services

Code

Description

H0038

CIPSS-Self Help/Peer Services

H0040

Assertive Community Treatment

H2012

Behavioral Health Day Treatment

H2014

Skills Training and Development

H2015

Community Integration Services

H2017

Daily Living Supports

H2018

Community Rehabilitation Services

H2025

Skills Development Services/Training

Section 28, Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations

Code

Description

H2021

Services for Children with Cognitive Impairments and Functional Limitations (all modifier combinations included)

G9007

Community-Based Wrap Around Services

Section 65, Behavioral Health Services

Code

Description

H0018

Crisis Residential (all modifier combinations included)

H2011

Crisis Resolution (all modifier combinations included)

H2012

Children’s Behavioral Health Day Treatment (all modifier combinations included)

H2021

Home- and Community-Based Treatment (HO, HN, and HU or HU/U1 modifiers)

H2021

Functional Family Therapy (HE modifier)

H2030

Clubhouse Services

H2033

Multisystemic Therapy (all modifier combinations included)

S9482

Crisis Residential In-home (all modifier combinations included)

 

Payments are proportionate to revenue loss experienced during the pandemic. Payments are calculated by comparing provider revenue for these services from a baseline period six months prior to the pandemic (September 2019 – February 2020) to revenue for the same six months during the pandemic (September 2020 – February 2021). To be eligible to receive these special payments, MaineCare must be able to identify claims for the relevant services with dates of service between September 2020–February 2021. Providers that did not experience a MaineCare revenue loss within a relevant section of policy during the pandemic timeframe will not receive a payment for that section of policy. Revenue losses are calculated separately for each pay-to provider for each section of policy. 

The payments will be included as part of this week’s payment cycle and will be indicated as an “OTHER” payment on the Summary page of the paper remittance advice (RA) and as an invoice number beginning with “BHSUP4” on the 835. 

Please contact your provider relations specialist with questions.