Section 50, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID): Retro Rate Updates for Day Habilitation Services, CR# 142634
It has come to our attention that several rate updates for Section 50 Day Habilitation services (0907) were delayed or not implemented at all. As a result, claims will require reprocessing to address incorrect payments.
The table below identifies the correct rates, effective dates, and the date we implemented the new rates. You can find these rates on the corresponding year of the Section 21 fee schedules that were released with each rate change announcement.
|
Effective Dates |
Prior Rate |
New Rate |
Date Implemented |
|
1/1/2025 – 6/30/2025 |
$8.93 |
$8.42 |
11/4/2026 |
|
7/1/2025 – 12/31/2025 |
$8.42 |
$8.58 |
11/4/2026 |
|
1/1/2026 – 12/31/2026 |
$8.58 |
$8.67 |
9/16/2026 |
Adjustment Billing Guidance for Dates of Service January 1, 2025 - November 4, 2026
- MaineCare will adjust paid claims that were submitted with charges at or above the correct rates.
- Providers are responsible for adjusting claims submitted with charges below the correct rates. Per policy, and to avoid timely filing denials, adjustments must be submitted within one year of the most recent claim payment date. Please adjust the oldest dates of service first. For additional billing guidance please see the How to Adjust Claims for a Retro Rate Change (PDF).
For questions, please contact your Provider Relations Specialist.