Important Reminder for MaineCare Benefits Manual (MBM), Chapter II, Section 46: Psychiatric Hospitals on Observation Stays Billing Requirements
Maine Department of Health & Human Services sent this bulletin at 04/10/2026 09:00 AM EDT
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This is a reminder of the existing rules and guidance for outpatient observation hours when submitting claims for Section 46: Psychiatric Hospitals. Providers must bill outpatient observation hours ONLY during outpatient visits. Following inpatient admission, providers may not bill MaineCare for outpatient observation hours occurring during the inpatient stay.
In accordance with MBM, Section 46.01-7, coverage for outpatient services delivered by Section 46: Psychiatric Hospital Providers is limited to visits less than 24 hours in duration.
For questions, please contact Tiffany Norton, Provider Relations Specialist.
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