10-144-101 Me. Code R. § III-32
Current through 2024-46, November 13, 2024
| Procedure Code | Modifier | Description | Unit of Service | Maximum allowance |
| T2017 | HA | HOME SUPPORT (Habilitation, residential, waiver)-Family | 1/4 hour | $6.33 |
| T2017 | HA TJ | HOME SUPPORT (Habilitation, residential, waiver) -Agency | 1/4 hour | $6.33 |
| T2016 | HA | HOME SUPPORT (Habilitation, residential, waiver) -Family | Per diem | $265.83 |
| T2016 | HA TG | level of support | Per diem | $502.79 |
| T2016 | HATJ | HOME SUPPORT (Habilitation, residential, waiver) -Agency | Per diem | $353.91 |
| S5150 | HA | RESPITE | 1/4 hour | $3.00 |
| S5151 | HA | RESPITE | Per diem | $90.00 |
| S5165 | HA | HOME ACCESSIBILITY ADAPTATIONS (Home Modifications) | Per itemized invoice | |
| S5165 | CG HA | Repairs | Per itemized invoice | |
| V5274 | HA | COMMUNICATORS (INCLUDING REPAIR AND MAINTENANCE), ASSISTIVE DEVICES | Per itemized invoice | |
| G9007 | HA HP | CONSULTATION-Psychiatric | 1/4 hour | $63.75 |
| G9007 | HA AH | CONSULTATION-Psychological | 1/4 hour | $19.80 |
| G9007 | HA GP | CONSULTATION-Physical Therapy | 1/4 hour | $5.40 |
| G9007 | HA GN | CONSULTATION-Speech Therapy | 1/4 hour | $5.40 |
| G9007 | HAGO | CONSULTATION-Occupational Therapy | 1/4 hour | $5.40 |
| G9007 | HA | CONSULTATION-Recreational Therapy | 1/4 hour | $5.40 |
| G9007 | HA HI | CONSULTATION-Behavioral | 1/4 hour | $21.00 |
| Modifiers - | TJ- | Agency Home Support |
| TG- | Increased Level of Support | |
| HA- | Child | |
| HP- | Psychiatric Consultation | |
| AH- | Psychological Consultation | |
| GP- | Physical Therapy | |
| GN- | Speech Therapy | |
| GO- | Occupational Therapy | |
| HI- | Behavioral Consultation | |
| CG- | Repairs for Home Modifications |
10-144 C.M.R. ch. 101, § III-32