Maine Medicaid private duty nursing rates stand apart for the codes they use as much as for the dollars. MaineCare pays $9.06 per 15 minutes for RN private duty nursing on code G0299, or $36.24 an hour, rank 34 of 43 states and 33.9% below the national median of $54.84. LPN care on G0300 pays $6.43 per 15 minutes, or $25.72 an hour, rank 30 of 39 and 41.7% below the median.
Most states bill private duty nursing on S9123, S9124 or T1000. Maine bills it on the G0299 and G0300 skilled-nursing codes, with modifiers that mark the level of nurse and the shift setting. For an agency moving into Maine from another state, the coding is the first thing to relearn, and the wage picture is the second.
Both MaineCare rates took effect January 1, 2026, and both are billed in 15-minute units.
| Service | Code and modifiers | Per 15 min | Per hour | Rank | vs median |
|---|---|---|---|---|---|
| Private duty nursing, RN | G0299 TD, UN | $9.06 | $36.24 | 34 of 43 | -33.9% |
| Private duty nursing, LPN | G0300 TE, UN | $6.43 | $25.72 | 30 of 39 | -41.7% |
The TD modifier identifies RN care and TE identifies LPN care, the same convention many states use on their own nursing codes. The UN modifier appears on both lines.
Maine does not post a separate waiver nursing rate ranked here. The comparison is state plan private duty nursing only, so Maine is not ranked against the higher waiver nursing medians of $77.60 for RN care and $56.42 for LPN care.
Unlike states whose nursing rates date back decades, Maine's rates are current: both lines carry a January 1, 2026 effective date. Many MaineCare fee schedules are published for a calendar year, running January 1 through December 31, which suggests that nursing rates are reviewed on the same cycle.
For agencies, a current date is useful in two ways. It means the published rate reflects a recent decision, not an outdated one, and it gives a predictable point in the year to revisit budgets. It also means the low rank is a present policy outcome rather than a legacy problem. Agencies seeking higher rates are dealing with a schedule the state has recently reviewed, which shapes how advocacy and comment on rulemaking should be framed.
Because Maine relies on G0299 for RN shifts and G0300 for LPN shifts, claims built around S9123 or T1000 habits from other states will not match the MaineCare schedule. The level of nurse is carried by the modifier, so a missing or wrong TD or TE modifier changes the rate the claim is priced against.
Practical billing steps
- Confirm the code and modifier pair for each nurse on the case before the first claim.
- Bill in 15-minute units, documenting start and stop times precisely; four units make an hour.
- Check effective dates when a claim spans January 1, since rate changes take effect at the turn of the year.
- Keep home health and private duty billing separate if the agency offers both, because the same G-codes may appear on both lines.
Maine's nurse wage picture is unusual. The median RN wage, $41.82 an hour, is below the US median of $46.90. The median LPN wage, $35.19, is above the US LPN median of $30.96. In other words, Maine's RN wages run low while its LPN wages run high, relative to the country.
Set against MaineCare's rates, both tiers come up short once employer costs are loaded:
- RN private duty nursing (G0299): the loaded median RN wage is 164.0% of the $36.24 rate, a margin of -$23.20 an hour.
- LPN private duty nursing (G0300): the loaded median LPN wage is 194.5% of the $25.72 rate, a margin of -$24.30 an hour.
These figures compare the published fee-for-service rate with a median wage. Agencies whose pay scale, overhead or hours mix differ from the median will see different results.
The LPN line is the weaker of the two, which reverses the usual pattern. In most of the country, LPN shifts are the more forgiving way to staff a private duty case, because LPN wages are much lower than RN wages while the rates sit closer together. In Maine, the combination of a relatively high LPN wage and a low LPN rate removes that cushion. An agency staffing a case with LPNs at the median wage loses slightly more per hour than one staffing it with RNs.
That has real consequences for how Maine agencies plan. The common strategy of covering long pediatric shifts with LPNs and reserving RNs for assessment does not save money here. Instead, agencies tend to staff by availability and clinical need, recruit nurses who value predictable schedules, and keep travel short in a largely rural state where distances between homes can erase what little margin a shift carries.
MaineCare is listed as a fee-for-service program. Its home and community-based programs are organized by sections of the MaineCare Benefits Manual and are also fee-for-service:
- Section 19: Home and Community Benefits for the Elderly and Adults with Disabilities.
- Section 21: Home and Community Based Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder.
- Section 20: Home and Community Based Services for Adults with Other Related Conditions.
- Section 29: Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder.
- Section 18: Home and Community Based Services for Adults with Brain Injury.
MaineCare has proposed rulemaking on Section 20 allowances for adults with other related conditions. Agencies serving those members should follow the proposal, since allowance changes can affect how many nursing hours a care plan can support.
Maine does not classify private duty nursing, home health or home and community-based services under any managed-care payment rule. The plan entries listed for Maine are largely transportation brokers and regional organizations rather than comprehensive medical plans. For private duty nursing, that leaves the published MaineCare rate as the figure that governs payment.
The upside is simplicity: there is one rate, set by the state, and no plan-by-plan negotiation. The downside is that there is no contract lever to raise it. Changes to the rate come through the state's schedule and rulemaking. The Maine managed-care page shows what is published for each line.
The gap between Maine and the top of the ranking is wide. On RN private duty nursing, Utah pays $254.03 an hour, Massachusetts $130.64, Georgia $95.36, Rhode Island $94.40 and Hawaii $94.04. On LPN care, Massachusetts leads at $90.96, followed by South Dakota at $77.36 and Utah at $75.10.
Maine is also well clear of the bottom. The lowest RN rates are Virginia at $25.86, New Jersey at $15.75 and Oklahoma at $8.92. That places Maine in the lower third for RN care and below the middle for LPN care. For agencies near the New Hampshire line or with ties to Massachusetts, the regional contrast is a recruiting factor, since nurses can compare pay across state lines.
- Budget per hour at the published rate. With no managed-care layer, revenue is hours delivered times the MaineCare rate.
- Do not assume LPN savings. In Maine, LPN hours carry a slightly worse margin than RN hours at the median wage.
- Review each January. Rates take effect at the turn of the calendar year.
- Follow rulemaking. Section-level proposals, such as the Section 20 allowance change, can shift hours as much as rates do.
With both lines below a median-wage nurse's cost, case selection in Maine is mostly about staffing reliability and travel:
- Which MaineCare section authorized the hours? State plan private duty nursing and the Section 18 through 29 programs each follow their own process.
- Is the correct code and modifier pair on the authorization? G0299 with TD and UN, or G0300 with TE and UN.
- How far is the home from available nurses? Long rural drives are unpaid and fall on an already negative margin.
- Can the family's schedule be covered consistently? Unfilled shifts hurt the family and the agency's standing with referral sources.
Agencies that know these answers before the first shift can focus on cases they can sustain, which in Maine's rate environment is the most direct way to protect both care quality and finances.
Rates on this page are compiled from official state Medicaid publications, and every rate links to its source document. For Maine, the main source is the MaineCare Fee Schedule (MaineCare UCR). The Maine Medicaid rates page lists all 27,586 current MaineCare rates across 6 programs.
Rankings compare each state's rate per hour for the same service and provider level. The private duty nursing rates by state overview ranks Maine against the rest of the country, our methodology explains how 15-minute units become hourly figures, and pricing covers full access to rate history and sources.