Similarities and Differences MaineCare vs. Medicare DRGs
Similarities and Differences MaineCare vs. Medicare DRGs
Similarities and Differences MaineCare vs. Medicare DRGs
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<strong>MaineCare</strong> APCs<br />
•<br />
• Recognition of <strong>Medicare</strong> Addendum B as the<br />
basis for acceptable reimbursable APCs<br />
– https://www.cms.gov/HospitalOutpatientPPS/AU/itemdetai<br />
l.asp?filterType=none&filterByDID=-<br />
99&sortByDID=3&sortOrder=descending&itemID=CMS12<br />
52388&intNumPerPage=10<br />
• Some CPT/HCPC codes not approved by <strong>Medicare</strong><br />
are accepted by <strong>MaineCare</strong>; currently under analysis<br />
by State<br />
• State planning to stay current with CMS maintenance<br />
schedule<br />
– Annual with quarterly updates •<br />
21
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