Attention Behavioral Health Service Providers: Behavioral Health Supplemental Payment Information

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.