(1) Providers must bill for services using the procedure codes and modifiers set forth, and according to the definitions contained, in the Health Care Financing Administration's Common Procedure Coding System (HCPCS). Information regarding billing codes, modifiers and HCPCS is available upon request from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

(2) Subject to the requirements of this rule, the Montana Medicaid program pays the following for therapy services:

(a) For patients who are eligible for Medicaid, the lower of:

(i) the provider's usual and customary charge for the service; or

(ii) the reimbursement provided in accordance with the methodologies described in ARM 37.85.212.