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

Current through 2024-29, July 17, 2024
PROC CODE
MODIFIER
DESCRIPTION
UNIT OF SERVICE
*MAXIMUM ALLOWANCE
Through 7/31/18
*MAXIMUM ALLOWANCE
8/1/18-6/30/19
*MAXIMUM ALLOWANCE
Effective 7/1/19
H2021
HI
Treatment services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								1:1
15 Minutes
$9.02
$10.68
$10.54
H2021
HQ
HI
UN
Treatment services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								GROUP- UN two patients served
15 MINUTES
$4.77
$5.36
$5.32
H2021
HQ
HI
UP
Treatment services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								GROUP- UP three patients served
15 MINUTES
$3.26
$3.69
$3.66
H2021
HQ
HI
UQ
Treatment services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								GROUP- UQ four patients served
15 MINUTES
$2.51
$2.86
$2.83
H2021
HK
specialized services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								1:1
15 minutes
$12.46
$14.79
$14.59
H2021
HQ
HK
UN
specialized services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								Group- UN two patients served
15 minutes
$6.48
$7.47
$7.38
H2021
HQ
HK
UP
specialized services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								Group- UP three patients served
15 minutes
$4.40
$5.11
$5.05
H2021
HQ
HK
UQ
specialized services for children with cognitive
								impairments and functional limitations (community based wrap around services)
								Group- UQ four patients served
15 minutes
$3.36
$3.97
$3.91
G9007
HA
BCBA services
15 MINUTES
$16.60
$16.60
P.L. 2017, ch. 460, Part C, Sec. C-1 directed that
					 rulemaking authorized by the Sec. C-1 law would be "major substantive" rules.
					 Sec. C-1 provided for certain rate increases, and rulemaking, for Section 28
					 services.
Providers must ensure that the 2% increase in reimbursement
					 rates as required via P.L. 2017, Ch. 460 Part D,effective August 1, 2018 is
					 applied in full to wages and benefits for employees who provide direct
					 services. Providers must document compliance with this requirement in their
					 financial records and provide such documentation to the Department upon
					 request.
*The Department is seeking and anticipates receiving CMS
					 approval for this Section. Pending approval, theDepartment will reimburse
					 providers under the new increased rate retroactively to8/1/2018 pursuant to
					 P.L. 2017, ch. 460.
Definition of Modifiers
HQ: group
HI: base service
HK: Specialized Services
UN: two patients served
UP: three patients served
UQ: four patients served