37.85.220    INDEPENDENT DIAGNOSTIC TESTING FACILITIES

(1) Any facility that is enrolled in the federal Medicare program as an independent diagnostic testing facility (IDTF) may also enroll in the Montana Medicaid program as an IDTF.

(2) IDTFs enrolled in the Montana Medicaid program shall be governed by 42 CFR 410.32 and 410.33. The department hereby adopts and incorporates by reference 42 CFR 410.32 and 410.33 (2001). Copies of 42 CFR 410.32 and 410.33 (2001) are available upon request from the Department of Public Health and Human Services, Health Policy and Services Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

(3) In addition to 42 CFR 410.32 and 410.33, IDTFs enrolled in the Montana Medicaid program shall comply with all rules generally applicable to Medicaid providers.

(4) An IDTF shall be reimbursed for diagnostic services performed pursuant to this rule in accordance with ARM 37.85.406 and 37.86.105.

(5) The definitions found in the introduction to Physicians Current Procedural Terminology, fourth edition (CPT4), published by the American Medical Association of Chicago, Illinois and adopted at ARM 37.86.101 set forth meanings of terms commonly used by the Montana Medicaid program in implementation of the program's IDTF fee schedule.

(6) The Physician-Related Services Manual governing the administration of the IDTF program adopted at ARM 37.86.101 applies to independent diagnostic testing facilities.

 

History: 53-6-113, MCA; IMP, 53-6-111, MCA; NEW, 2002 MAR p. 797, Eff. 3/15/02; AMD, 2012 MAR p. 2625, Eff. 1/1/13.