How to start an IDD waiver provider in Maine
Maine requires a Home and Community Support Services Agency license (service-specific) under 10-144 CMR Ch. 108, plus OADS approval as a MaineCare Section 21 / Section 29 waiver provider from Maine DHHS Division of Licensing and Certification (DLC) jointly with the Office of Aging and Disability Services (OADS) to operate an IDD waiver provider.
- License required
- YesHome and Community Support Services Agency license (service-specific) under 10-144 CMR Ch. 108, plus OADS approval as a MaineCare Section 21 / Section 29 waiver provider
- Application fee
- —
- Processing time
- —
- In-home and community living supports (IDD)
- $11.26per 15 min · $45.04/hr
- Organizations in the state
- 418NPPES, Sep 13, 2026
On this page
Maine idd waiver provider license
Maine requires a Home and Community Support Services Agency license (service-specific) under 10-144 CMR Ch. 108, plus OADS approval as a MaineCare Section 21 / Section 29 waiver provider from Maine DHHS Division of Licensing and Certification (DLC) jointly with the Office of Aging and Disability Services (OADS) to operate an IDD waiver provider.
- License required
- Yes
- License
- Home and Community Support Services Agency license (service-specific) under 10-144 CMR Ch. 108, plus OADS approval as a MaineCare Section 21 / Section 29 waiver provider
- Issuing agency
- Maine DHHS Division of Licensing and Certification (DLC) jointly with the Office of Aging and Disability Services (OADS)
- Survey and inspection
- OADS and DLC jointly conduct licensing reviews against administrative, physical plant and program standards that differ by service.
- Regulation
- 10-144 CMR Ch. 108 (Home and Community Support Service Agencies Licensing Rule); MaineCare Benefits Manual Ch. II Sections 21 and 29
Steps to get licensed in Maine
In order, as the licensing agency describes the process.
- Define the waiver services you will offer (Section 21 comprehensive or Section 29 support services for adults with ID or autism)
- Determine whether the services need licensing or staff certifications; since late 2025 case management, home support, shared living, day and employment agencies need a DLC Home and Community Support Services license
- Learn MaineCare Benefits Manual Chapter I Sections 1 and 6 and the Chapter II service sections
- Apply to OADS through its online application portal (initial applications paused since April 13, 2026)
- Complete the DLC/OADS licensing review and enroll as a MaineCare provider
Enrolling as a Maine Medicaid provider
- Program
- MaineCare (Office of MaineCare Services, Maine DHHS)
- Fiscal agent
- Gainwell Technologies (MaineCare provider enrollment vendor/MIHMS)
- Application fee
- MaineCare charges the fee to providers that are newly enrolling, revalidating or adding a practice location, unless exempt, paid by debit or credit card in the Trading Partner Account; its fee spreadsheet lists the provider types that pay. Home health agencies and DME suppliers must also post a surety bond at enrollment, revalidation and new locations. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
- Fingerprinting
- MaineCare runs automated criminal history checks on all providers and on 5%+ owners, board members, managing employees and rendering providers. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.
- Site visit
- MaineCare does site visits on revalidating provider locations assigned moderate or high risk; risk is set by provider type and service-location specialty (Risk Category Assignments, May 2024). Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.
- Revalidation
- MaineCare revalidates at least every five years (every three years for DME providers) or whenever it asks; it has a federally required 2026-2028 off-cycle revalidation plan. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.
Does Maine require a certificate of need?
- CON program
- Yes
- Program
- Certificate of Need (Maine Certificate of Need Act of 2002)
- Agency
- Maine Department of Health and Human Services (CON Unit, Division of Licensing and Certification)
- Services covered
- hospitals and psychiatric hospitals
- nursing facilities
- kidney disease treatment centers / freestanding hemodialysis
- rehabilitation facilities
- ambulatory surgical facilities
- independent radiological service centers
- independent cardiac catheterization centers
- cancer treatment centers
- transfers of ownership or control of a health care facility
- major medical equipment acquisitions
Electronic visit verification in Maine
- Model
- hybrid
- State vendor
- Sandata (through fiscal agent Gainwell Technologies)
- Services in scope
- personal care
- home health
- Alternate EVV allowed
- Yes
Maine wage floor
- State minimum wage
- $15.10 an hour
- Effective
- 2026-01-01
- Scheduled increases
- Rises to $15.70 on 2027-01-01 (CPI-W Northeast indexing).
- Direct-care wage floor
- MaineCare and state-funded reimbursement for essential support workers must build in at least 125% of the state minimum wage for the labor portion of the rate, plus related taxes and benefits, updated whenever the minimum wage rises (in effect since 2022-01-01). This is a rate floor, not a direct wage mandate on employers.
- HCBS 80/20 rule
- Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.
Maine market size
Counts from federal public files: NPPES (active organization NPIs), CMS Care Compare and CMS Medicaid enrollment.
- Intellectual/developmental disability residential facilities — active organization NPIs (NPPES)
- 418 (as of Sep 13, 2026)
- Total Medicaid and CHIP enrollment (latest reported month)
- 327,698 (as of Jun 1, 2026)
What Maine Medicaid pays
Intellectual & developmental disabilities: published Maine fee-for-service rates, each linked to its source.
| Service | Code | Maine rate | Per hour | Rank |
|---|---|---|---|---|
| In-home and community living supports (IDD)Agency provider | T2017 | $11.26per 15 min | $45.04 | 9 of 29 |
| Community integration / community access (IDD)Agency provider | T2021 | $8.21per 15 min | $32.84 | 8 of 22 |
| Day habilitation / day program (IDD)Agency provider | T2021 | $7.04per 15 min | $28.16 | 13 of 32 |
| Residential habilitation / group home supportsAgency provider | T2016 | $34.64per hour | $34.64 | — |
| Supported employment (job coaching)Agency provider | H2023 | $5.35per 15 min | $21.40 | 33 of 39 |
Maine HCBS waivers
Medicaid home and community-based services programs that may pay for this service.
- Home and Community Based Services for Members with Brain Injury Waiver (1915(c))
- Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver (1915(c))
- Elderly and Adults with Disabilities Waiver (1915(c))
- Home and Community Based Services for Adults with Other Related Conditions Waiver (1915(c))
- Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver (1915(c))
Frequently asked questions
Do you need a license to start an IDD waiver provider in Maine?
Maine requires a Home and Community Support Services Agency license (service-specific) under 10-144 CMR Ch. 108, plus OADS approval as a MaineCare Section 21 / Section 29 waiver provider from Maine DHHS Division of Licensing and Certification (DLC) jointly with the Office of Aging and Disability Services (OADS) to operate an IDD waiver provider.
Does Maine require a certificate of need for an IDD waiver provider?
Maine has a certificate of need program covering: hospitals and psychiatric hospitals, nursing facilities, kidney disease treatment centers / freestanding hemodialysis, rehabilitation facilities, ambulatory surgical facilities, independent radiological service centers, independent cardiac catheterization centers, cancer treatment centers, transfers of ownership or control of a health care facility, major medical equipment acquisitions. Check whether your service is on that list.
How do you become a Medicaid provider in Maine?
Enroll through MIHMS Health PAS Online Portal — Provider Enrollment Application (PEA) via Trading Partner Account (moving to the new 'MaineCare Partner Portal' in late September 2026) (https://mainecare.maine.gov/default.aspx), run by Gainwell Technologies (MaineCare provider enrollment vendor/MIHMS).
What does Maine Medicaid pay a IDD waiver provider?
Maine Medicaid pays $11.26 per 15 min for in-home and community living supports (idd), effective Jan 1, 2026, ranking 9 of 29 states.