MECMS Billing Number

Change in Dates that the MECMS Billing Number is Required

The number of Maine Behavioral Health ASO registrations for service in December has been very high. As a result, DHHS has chosen to phase-in the MECMS PA billing requirement for services, to ensure that no provider billing is delayed.

All members newly admitted to services since December 1, 2007 are subject to the ASO requirements for Utilization Review and Prior Authorization, as described in the ASO Provider Manual regardless of the dates that the MECMS Billing Number is required. It is only the billing process that is being phased-in, not the PA and UR processes.

This Change Only Effects the Date to Include the MECMS PA Billing # on Claims Services will be required to submit a billing number with their claims to MaineCare according to the following schedule:

Date MECMS Billing Number is Required	Services Required to Submit a MECMS Billing Number
January 1, 2008	Section 17 Community Support Services-Except CI Section 65 Crisis Supports (Crisis Units) - Adult & Child Section 65 Child ACT Section 65M&N- Included for MECMS PA No. Section 97 PNMI, Adult, Sub. Abuse & Child Mgmt
February 1, 2008	Section 17 Community Integration Services Section 13 Targeted Case Management
March 1, 2008	Section 58 Services, both Adult & Child Section 65 Adult Home Based Services Section 65 Med Mgmt, both Adult & Child Section 65 Outpatient Therapy, both Adult & Child Section 65 Family Psychoeducation Section 65 Day Treatment- Child Section 65 Infant Mental Health Section 100 Psychological Services Section 111 Substance Abuse- Routine Outpatient

Important Considerations:

1. This change only effects the date that you are required to include the MECMS PA Billing Number on the billing form, for services noted above.

2. This change applies to both Transition and newly admitted members.

3. Do not submit MECMS PA Billing Numbers with billing, for service dates prior to the dates listed above for the noted services. Even if you are issued a MECMS PA Billing Number prior to the listed dates, do not submit it on your billing forms until the listed date for your service.

4. All remaining registrations for members in service prior to 12/1/07 should have an authorization start date of no later than 1/1/08.

Please see the revised Service Grid (v12/19/07) for the MECMS billing start date for specific procedure codes.