Provider Type Reminder for School Health Related and Home and Community Services
The chart below is intended to support enrollment requirements by outlining covered service delivery limitations for the following provider types:
- Public Schools (87)
- Special Purpose Private Schools (88)
- Intermediate Education Units (CDS Only – 89)
- Early Childhood Providers (92)
- Children’s Community Rehabilitation Providers (86).
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Public Schools (87) |
Special Purpose Private Schools (88) |
Intermediate Education Units (89) (CDS Only) CDS Regional Offices |
Intermediate Education Units (89) (CDS Only) CDS Preschools |
Early Childhood Providers (92) |
Children’s Community Rehabilitation (86) |
|---|---|---|---|---|---|---|
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Maine Division of Licensing Approval
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Mental Health Agency License |
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✓ |
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DOE Approval
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DOE Approval to Operate |
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✓ |
✓ |
✓ |
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Child Care License Required |
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✓ |
✓ |
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Age of Members
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Under 3 years of age |
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✓ |
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Ages 3-5 |
✓* |
✓* |
✓ |
✓ |
✓ |
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Grades K-12 |
✓ |
✓ |
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Members age 0-20 |
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✓ |
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Covered Services Delivered
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Sections 68, 85, 109 Therapy Services (Speech, PT/OT) |
✓ |
✓ |
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Section 13 Targeted Case Management |
✓** |
✓** |
✓** |
✓** |
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Section 96 Private Duty Nursing |
✓ |
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Section 28 Adaptive Behavior Services |
✓ |
✓ |
✓ |
✓ |
✓ |
✓ |
|
Section 65 Behavioral Health Services |
✓ |
✓ |
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|
✓ |
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IEP Documentation Requirement
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Delivers Services on an IEP |
✓ |
✓ |
✓ |
✓ |
✓ |
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Delivers Services not on IEP |
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✓ |
✓ |
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Service Delivery Setting
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Delivers services in school setting |
✓ |
✓ |
✓ |
✓ |
✓ |
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Delivers services outside facility |
✓ |
|
✓ |
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|
✓ |
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Billing
|
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Bills for Direct Services |
✓ |
✓ |
✓ |
✓ |
✓ |
✓*** |
|
Bills for Contracted Providers |
✓ |
✓ |
✓ |
✓ |
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|
✓* Requires additional approval from the Maine Department of Education.
✓** Requires additional service location enrollment.
✓*** This provider type can only bill directly for services delivered primarily in home and community settings. Schools may contract with this provider type for services however the school must be the enrolled MaineCare provider.
For questions, please contact your Provider Relations Specialist.