Maine.gov



PROCCODEMODIFIERDESCRIPTIONUNITMAXIMUM ALLOWANCET1016U8Care Coordination (Case Management)? hour$ 17.00T2021U8Community Support (Day Habilitation)? hour$ 5.33*T2016U8Home Support (Residential Habilitation)Per Diem$ 287.91*T2017U8Home Support (Residential Habilitation)? hour$ 6.39*T2017U8 QCHome Support (Residential Habilitation)-Remote Support-Monitor Only? hour$ 1.63*T2017U8 GTHome Support (Residential Habilitation)-Remote Support-Interactive Support? hour$ 6.39*T1019U8Personal Care ? hour$ 3.78*H2023U8Work Support (Supported Employment)? hour$ 6.91T2019U8Employment Specialist Services (Habilitation-Supported Employment)? hour$ 7.49*97755U8Assistive Technology-Assessment? hour$ 16.04T2035U8Assistive Technology-Transmission (Utility Services)MonthUp to $50.00 per monthA9279U8Assistive Technology-(Monitoring feature/device, stand alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified)Up to $6,000.00 annuallyV5274U8Communication AidsPer invoiceG9007U8 GNConsultation -Speech? hour$ 5.40G9007U8 GOConsultation -Occupational Therapy? hour$ 5.40G9007U8 GPConsultation -Physical Therapy? hour$ 5.40H0031U8Consultation -Psychological (Psychologist, Psychological Examiner)? hour$ 19.80G9007U8 HIConsultation –Behavioral (LCSW,LCPC)? hour$ 13.50S5165U8Home Accessibility Adaptations (Home Modifications)Per invoiceS5165U8 CGHome Accessibility Adaptations (Home Modifications)-RepairsPer invoiceT2029U8Specialized Medical EquipmentPer invoiceS8990U8 GOMaintenance-Occupational Therapy? hour$ 9.54S8990U8 GNMaintenance-Speech Therapy? hour$ 12.48S8990U8 GPMaintenance-Physical Therapy? hour$ 9.7292507U8Non-Traditional Communication-Assessment (Treatment of speech, language, voice, communication, and or auditory processing disorder; individual)? hour$ 9.00G9007U8Non-Traditional Communication-Consultation? hour$ 9.00T2015U8Career Planning (Habilitation, prevocational)Per Hour$ 28.00**Table for ModifiersGT362077029210*The effective date of this rate change is retroactive to April 15, 2016.**The effective date of this rate change is March 1, 201700*The effective date of this rate change is retroactive to April 15, 2016.**The effective date of this rate change is March 1, 2017Remote Support-Interactive SupportQCRemote Support-Monitor OnlyGNSpeech Therapy ServicesGOOccupational Therapy ServicesGPPhysical Therapy ServicesHIBehavioral ServicesCGRepairsU8All Section 20 Services ................
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