37.87.1215    PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY SERVICES, ASSESSMENT SERVICES

(1) Psychiatric residential treatment facility (PRTF) assessment services are provided by in-state PRTF facilities and must comply with the requirements of this subchapter and the applicable federal regulations for PRTF services.

(2) PRTF assessment services:

(a) require prior authorization by the department or its designee;

(b) are short-term lengths of stay, 14 days or less;

(c) are reimbursed 15% higher than the department's current Medicaid Youth Mental Health Fee Schedule for PRTF Services.

(3) Assessment services include the following, as clinically indicated:

(a) diagnostic and functional assessment;

(b) medication evaluation;

(c) psychological and IQ testing;

(d) substance use disorder assessment; and

(e) supported group or independent living needs assessment.

(4) Assessment services include a written report within 14 days after the discharge that includes clear recommendations for treatment of the youth.

(5) If the PRTF admission continues beyond the assessment period and becomes a regular admission, the department will not reimburse at the higher rate for assessment services.

(a) If the youth is re-admitted to the facility within 30 days of the assessment, the admission for assessment may be subject to department review and full recovery.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, MCA; NEW, 2008 MAR p. 2360, Eff. 1/1/09; AMD, 2015 MAR p. 2147, Eff. 12/11/15.