37.87.733    MENTAL HEALTH CENTER SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE (SED), REIMBURSEMENT

(1) Medicaid reimbursement for mental health center services shall be the lesser of:

(a) the provider's actual (submitted) charge for the service; or

(b) the rate established in the department's Medicaid fee schedule, as adopted in ARM 37.85.105.

(2) For day treatment services, the department will not reimburse a mental health center provider for more than one fee per treatment day per youth. This does not apply to mental health professional services to the extent such services are separately billed in accordance with these rules or targeted case management services for youth with SED.

History: 53-2-201, 53-6-101, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, MCA; NEW, 2009 MAR p. 272, Eff. 2/27/09; AMD, 2010 MAR p. 1512, Eff. 7/1/10; AMD, 2012 MAR p. 1273, Eff. 7/1/12; AMD, 2013 MAR p. 2153, Eff. 11/15/13