10-144-101 Me. Code R. § III-20
PROCCODE | MODIFIER | DESCRIPTION | UNIT | MAXIMUM ALLOWANCE | ||
T1016 | U8 | Care Coordination (Case Management) | 1/4 hour | $17.00 | ||
T2021 | U8 | Community Support (Day Habilitation) | 1/4 hour | $5.33* | ||
T2016 | U8 | Home Support (Residential Habilitation) | Per Diem | $287.91* | ||
T2017 | U8 | Home Support (Residential Habilitation) | 1/4 hour | $6.39* | ||
T2017 | U8 QC | Home Support (Residential Habilitation)-Remote Support-Monitor Only | 1/4 hour | $1.63* | ||
T2017 | U8 GT | Home Support (Residential Habilitation)-Remote Support-Interactive Support | 1/4 hour | $6.39* | ||
T1019 | U8 | Personal Care | 1/4 hour | $ 3.78* | ||
H2023 | U8 | Work Support (Supported Employment) | 1/4 hour | $ 6.91 | ||
T2019 | U8 | Employment Specialist Services (Habilitation-Supported Employment) | 1/4 hour | $7.49* | ||
97755 | U8 | Assistive Technology-Assessment | 1/4 hour | $16.04 | ||
T2035 | U8 | Assistive Technology-Transmission (Utility Services) | Month | Up to $50.00 per month | ||
A9279 | U8 | Assistive Technology-(Monitoring feature/device, stand alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified) | Upto $6,000.00 annually | |||
V5274 | U8 | Communication Aids | Per invoice | |||
G9007 | U8 GN | Consultation -Speech | 1/4 hour | $5.40 | ||
G9007 | U8 GO | Consultation -Occupational Therapy | 1/4 hour | $5.40 | ||
G9007 | U8 GP | Consultation -Physical Therapy | 1/4 hour | $5.40 | ||
H0031 | U8 | Consultation -Psychological (Psychologist, Psychological Examiner) | 1/4 hour | $19.80 | ||
G9007 | U8 HI | Consultation -Behavioral (LCSW, LCPC) | 1/4 hour | $13.50 | ||
S5165 | U8 | Home Accessibility Adaptations (Home Modifications) | Per invoice | |||
S5165 | U8 CG | Home Accessibility Adaptations (Home Modifications)-Repairs | Per invoice | |||
T2029 | U8 | Specialized Medical Equipment | Per invoice | |||
S8990 | U8 GO | Maintenance-Occupational Therapy | 1/4 hour | $9.54 | ||
S8990 | U8 GN | Maintenance-Speech Therapy | 1/4 hour | $12.48 | ||
S8990 | U8 GP | Maintenance-Physical Therapy | 1/4 hour | $9.72 | ||
92507 | U8 | Non-Traditional Communication-Assessment (Treatment of speech, language, voice, communication, and or auditory processing disorder; individual) | 1/4 hour | $9.00 | ||
G9007 | U8 | Non-Traditional Communication-Consultation | 1/4 hour | $9.00 | ||
T2015 | U8 | Career Planning (Habilitation, prevocational) | Per Hour | $28.00** | ||
Table for Modifiers | ||||
GT | Remote Support-Interactive Support | |||
QC | Remote Support-Monitor Only | |||
GN | Speech Therapy Services | |||
GO | Occupational Therapy Services | |||
GP | Physical Therapy Services | |||
HI | Behavioral Services | |||
CG | Repairs | |||
U8 | All Section 20 Services | |||
* The effective date of this rate change is retroactive to April 15, 2016.
** The effective date of this rate change is March 1, 2017
10-144 C.M.R. ch. 101, § III-20
3/1/2017 - filing 2017- 030