Maine ABA Medicaid Rates Under MaineCare (2026)

ABA Medicaid rates in Maine are built on HCPCS codes rather than the 97151 to 97158 series: MaineCare pays $27.87 per 15 minutes for technician-level ABA under code H2021, with modifiers U1 and HK, effective 2026-01-01. Maine publishes no 97153 rate, so its technician rate sits outside the national 97153 ranking, where the median is $63.44 an hour across 44 states.

The one Maine rate that is ranked is caregiver training, billed under T1027 at $118.52 an hour. That places Maine 11th of 43 states, 25.0% above the national median of $94.80. All rates below are compiled from official MaineCare publications and link to their source documents on the Maine Medicaid rates hub.

All three rates took effect 2026-01-01. MaineCare publishes no rate for analyst protocol modification (97155), analyst assessment (97151), technician-assisted assessment (97152) or analyst-led groups (97158).

Most states bill ABA through the CPT series, and the national comparisons for 97153, 97155 and 97151 are built on that series. Maine uses H2021 for technician-level ABA, distinguished by modifiers: U1 and HK for individual services, with UP added for group services. That has four practical consequences:

1. Billing systems need Maine-specific code and modifier rules. An agency operating in several states cannot reuse its 97153 setup in Maine.
2. Rate comparisons need care. Maine's $27.87 per 15-minute unit is not in the national per-hour ranking, so it should be read against the national medians directly rather than by rank.
3. Group work has its own modifier. The UP modifier turns the H2021 service into a group service at $10.82 per 15 minutes, against $27.87 for individual work. Group rates are generally paid per participant, so revenue per staff hour depends on attendance; agencies should confirm the group-size rules before scheduling.
4. Analyst time must be mapped. With no published 97155 or 97151 rate, agencies should confirm how MaineCare reimburses BCBA assessment and treatment direction before staffing.

How modifiers carry the meaning

A modifier is a two-character suffix that tells the payer something about the service or provider. In Maine, the modifiers do the work that separate CPT codes do elsewhere: the same H2021 code becomes an individual or a group service depending on whether UP is present, and T1027 carries HA. A claim with a missing or extra modifier can price at the wrong rate or deny, so the modifier set should be built into the billing system once and applied automatically for each service.

Maine's best-documented rate is caregiver training. At $29.63 per 15 minutes, or $118.52 an hour, it ranks 11th of 43 states. The national leaders are Rhode Island ($219.88, also under T1027), Hawaii ($184.80) and Alaska ($167.88); the lowest are New Hampshire ($65.72), Idaho ($47.96 under T1027) and Louisiana ($21.00).

At the Maine analyst proxy wage of $28.83 an hour, wages take 34.6% of the T1027 rate, leaving $77.54 an hour after a loaded wage. That is a solid margin for family-training work, and it makes caregiver training one of the better-documented revenue lines for an ABA agency in Maine.

Building family training into treatment

Caregiver training is clinically valuable: families who practice the strategies used in therapy help skills carry over into daily life. In Maine, it is also one of the few ABA services with a clear, well-ranked rate. Treatment plans that set a regular family-training cadence with measurable caregiver goals align good practice with the schedule. Given the authorization burden on T1027, described below, those plans should be detailed enough to satisfy the review from the start.

MaineCare's coverage rules are dense:

• H2021: 16 prior-authorization rules.
• T1027: 59 prior-authorization rules.

No unit limits are published. The T1027 count is far higher than the H2021 count, and it signals a detailed, condition-heavy authorization process for caregiver training. Agencies should treat authorization as a dedicated function in Maine rather than a side task for clinicians, and build documentation templates that address each condition.

Practical steps for authorization staff

• Keep a checklist for each code that lists the documentation each rule requires.
• Submit caregiver-training requests with the treatment-plan goals they support.
• Track approval windows by client and code, and start renewals early.
• Reconcile authorized units with delivered units monthly so gaps surface before claims deny.

Maine's wage data sits slightly above national levels. The median wage for the closest comparable technician occupation was $22.94 an hour in May 2025, against $22.08 nationally; the analyst proxy was $28.83, against $28.53. Both are proxy occupations and understate pay for credentialed RBTs and BCBAs.

Because the H2021 technician rate is published per 15-minute unit and is not converted to an hourly ranking, no wage-share or margin figure is published for it here. Agencies should model it from the unit rate and their own expected billable hours, accounting for travel, cancellations and supervision time, which in a largely rural state can be significant.

Maine's programs are all fee-for-service. They include MaineCare fee-for-service and several waivers administered under the MaineCare Benefits Manual, among them Home and Community Based Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder (Section 21) and Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder (Section 29). No managed-care service-line rule applies to ABA, so the MaineCare schedule is the operative rate. The seven organizations on file are mainly transportation brokers and care coordinators rather than risk-bearing plans; the Maine managed-care page lists them.

For an ABA agency, that structure is simple: one schedule, one set of rules and one update cycle, with no plan contracts to negotiate. Agencies serving young adults should also know the Section 21 and Section 29 programs, since many clients move into those supports after childhood services end, and a planned handoff helps families avoid gaps in support.

Maine's geography shapes ABA economics as much as its rates do. Many families live far from clinic hubs, so in-home sessions often involve long drives that are not billable. With technician ABA paid per 15-minute unit, every hour a technician spends driving is an hour with no units, and a caseload spread across a county can leave technicians delivering far fewer billable hours than they are paid for.

Agencies that work well in Maine tend to make three choices. They cluster caseloads geographically, so technicians see several clients in one area each day. They use clinic-based sessions where clinically appropriate, especially for groups billed under H2021 with UP, where several participants need to be in one place. And they schedule caregiver training, the best-ranked Maine rate, in ways that fit families' routines, including sessions alongside a child's regular technician visit when the treatment plan supports it.

None of these choices changes the published rates, but together they determine how much of a technician's paid time turns into billable units, which is the number that decides whether a Maine ABA program covers its costs.

MaineCare's recent activity has centered on hospitals, dental services, pharmacy dispensing fees and FQHC rate letters for fiscal year 2027. A State Plan Amendment for the MaineCare Accountable Communities Program was proposed on 2026-09-30. None of these targets ABA rates directly. Because Maine's ABA rates all took effect 2026-01-01, the next change is most likely to arrive with an annual schedule update, and agencies should watch MaineCare provider notices around the start of each calendar year.

On 97153, the national leaders are Alaska ($127.80), Georgia ($123.64) and Iowa ($114.36), and the lowest are Louisiana ($40.00) and New York ($38.52). Maine sits outside that ranking because of its H2021 coding. For a New England operator, compare Massachusetts's ABA rates, which use the CPT series, and Connecticut's, which publishes a narrower CPT code set.

1. Set up Maine billing from scratch. H2021 with modifiers replaces the CPT codes most agencies use elsewhere, so test a few claims before scaling up.
2. Model technician revenue from the unit rate. Use $27.87 per 15 minutes and realistic billable hours, not national hourly benchmarks.
3. Make caregiver training a core service. It is Maine's best-ranked rate, is clinically valuable and leaves a solid margin.
4. Staff the authorization function. The rule counts on T1027 justify dedicated support.
5. Confirm analyst billing before hiring. Without published analyst codes, verify how BCBA time is paid.
6. Plan routes before caseloads. Geographic clustering is the single biggest lever on billable hours per technician in Maine.

Rates on this page are compiled from official MaineCare publications, including the MaineCare Fee Schedule (MaineCare UCR, HealthPAS report REF0060). Each rate in our dataset links to its source document, and hourly figures are the 15-minute unit rate multiplied to an hour where a rate is ranked. All 27,586 current Maine Medicaid rates, with history back to 2010, are available on our plans. The national ABA rates hub and our methodology explain how states that bill under HCPCS codes are compared.