C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-3, subsec. 144-101-II-3.08
Billing must be accomplished in accordance with the Department's "Billing Instructions for the CMS 1500 Claim Form".
MaineCare Services will replace the billing codes in Table 1, Chapter III, Section 3 with the codes found in Table 2 upon implementation of the new billing system. Providers will receive written notice thirty (30) days prior to implementation.
Each clinic must only bill using codes for sick child visits and, if applicable, all adult visits. Billing for Early and Periodic Screening Diagnosis and Treatment (EPSDT) and immunizations for well children may be billed under Chapter V of the MaineCare Benefits Manual as long as services are provided in conformance with all requirements of that Chapter, including submission of the Bright Futures form. Procedure codes for EPSDT services will be found in the Physicians' Current Procedural Terminology (CPT) manual.
C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-3, subsec. 144-101-II-3.08