Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter III - Allowances for Services › Section 144-101-III-96 - Private Duty Nursing and Personal Care Services

Current through 2024-29, July 17, 2024
PROCEDURE CODE
DESCRIPTION
UNIT
AMOUNT
Effective 7/29/16 to 2/21/17
AMOUNT
Effective 2/22/17 to 6/30/17 and 7/1/18 to
								7/31/18
AMOUNT
Effective 7/1/17 to 6/30/18
AMOUNT
Effective 8/1/18 to 6/30/19
AMOUNT
Effective 7/1/19
G0299 TD 0551
RN Services
15 minutes
$12.16
$12.16
$13.47
$13.88
$13.74
G0299 TD UN 0551
RN Services -multiple patients (2)
15 minutes
$6.94
$6.69
$7.41
$7.63
$7.56
G0299 TD UP 0551
RN Services - multiple patients (3)
15 minutes
N/A
$4.87
$5.39
$5.55
$5.50
G0300 TE 0559
LPN Services
15 minutes
$8.04
$8.04
$9.56
$9.90
$9.75
G0300 TE UN 0559
LPN Services - multiple patients (2)
15 minutes
$4.74
$4.43
$5.27
$5.45
$5.37
G0300 TE UP 0559
LPN Services - multiple patients (3)
15 minutes
N/A
$3.21
$3.83
$3.96
$3.90
T1000 TD
Independent RN
15 minutes
$10.96
$10.96
$13.47
$13.88
$13.74
T1000 TD UN
Independent RN - multiple patients (2)
15 minutes
$6.13
$6.03
$7.41
$7.63
$7.56
T1000 TD UP
Independent RN- multiple patients (3)
15 minutes
N/A
$4.39
$5.39
$5.55
$5.50
T1502
Administration of oral, intramuscular and/or
								subcutaneous medication
Per visit
$6.32
$6.32
$6.32
$8.09
$7.42
T1004 0571
Home Health Aide/ Certified Nursing Assistant
								Services
15 minutes
$4.90
$4.90
$5.39
$5.55
$5.50
T1004 UN 0571
Home Health Aide/Certified Nursing Assistant
								Services - multiple patients (2)
15 minutes
N/A
$2.70
$2.97
$3.05
$3.03
T1004 UP 0571
Home Health Aide/Certified Nursing Assistant
								Services - multiple patients (3)
15 minutes
N/A
$1.96
$2.16
$2.22
$2.20
T1019 0589
Personal Support Services (PSS)
15 minutes
$4.62
$4.62
$5.03
$5.18
$5.13
T1019
Personal Support Services (PSS) - (for PCA Agencies
								only)
15 minutes
$4.62
$4.62
$5.03
$5.18
$5.13
T1019 UN
Personal Support Services (PSS) - (for PCA Agencies
								only) multiple patients (2)
15 minutes
N/A
$2.54
$2.77
$2.85
$2.82
T1019 UP
Personal Support Services (PSS) - (for PCA Agencies
								only) multiple patients (3)
15 minutes
N/A
$1.84
$2.01
$2.07
$2.05
S5125 TF 0589
PCA Supervisit
15 minutes
$5.10
$5.10
$21.14 Per visit
$23.51 per visit
$21.57 per visit
S5125 TF UN 0589
PCA Supervisit - multiple patients (2)
15 minutes
N/A
$2.81
$11.64 per visit
$12.93 per visit
$11.87 per visit
S5125 TF UP 0589
PCA Supervisit - multiple patients (3)
15 minutes
N/A
$2.04
$8.46 per visit
$9.40 per visit
$8.63 per visit
S5125TF
PCA Supervisit (for PCA Agencies only)
15 minutes
$5.10
$5.10
$21.14 per visit
$23.51 per visit
$21.57 per visit
S5125 TF UN
PCA Supervisit (for PCA Agencies only) multiple
								patients (2)
15 minutes
N/A
$2.81
$11.64 per visit
$12.93 per visit
$11.87 per visit
S5125 TF UP
PCA Supervisit (for PCA Agencies only) multiple
								patients (3)
15 minutes
N/A
$2.04
$8.46 per visit
$9.40 per visit
$8.63 per visit
S5125
Personal Support Services (FPSO)
15 minutes
$3.72
$3.72
$3.72
$3.73
$3.73
S5125 UN
Personal Support Services (FPSO) multiple patients
								(2)
15 minutes
N/A
$2.04
$2.04
$2.05
$2.05
S5125 UP
Personal Support Services (FPSO) multiple patients
								(3)
15 minutes
N/A
$1.49
$1.49
$1.49
$1.49
H2014
Skills Training (FPSO only)
15 minutes
$14.03
$14.03
$14.03
$14.03
$14.03
G9001
Care Coordination Service (Initial Visit)
15 minutes
$17.00
$17.00
$17.00
$17.00
$17.00
G9002
Care Coordination Service (Maintenance
								Visit)
15 minutes
$17.00
$17.00
$17.00
$17.00
$17.00
S5120
Chore Services
15 minutes
$2.30
$2.30
$2.30
$2.30
$2.30