Montana Administrative Code

37.88.1405 INSTITUTIONS FOR MENTAL DISEASES, PROVIDER PARTICIPATION REQUIREMENTS An institution for mental diseases, as a condition of participation in the Montana medicaid program, under ARM 37.88.1401, 37.88.1402, 37.88.1405, 37.88.1406, 37.88.1410, 37.88.1411 and 37.88.1420 mu…

37.88.1406 INSTITUTIONS FOR MENTAL DISEASES, INDIVIDUAL TREATMENT PLANS Institutions for mental diseases providing services under ARM 37.88.1401, 37.88.1402, 37.88.1405, 37.88.1406, 37.88.1410, 37.88.1411 and 37.88.1420 must provide for and maintain recorded individual plans of t…

37.88.1410 INSTITUTIONS FOR MENTAL DISEASES, REIMBURSEMENT The Montana medicaid program does not cover and will not reimburse for services provided in institutions for mental diseases, except: services provided to medicaid recipients ages 18 through 21 and 65 or over in hospitals…

37.88.1411 INSTITUTIONS FOR MENTAL DISEASES, BILLING AND PAYMENT Providers must bill for all services and supplies in accordance with the provisions of ARM 37.85.406. The department will pay a provider on a monthly basis the amount determined in accordance with these rules upon r…

37.88.1420 INSTITUTIONS FOR MENTAL DISEASES, ADMINISTRATIVE REVIEW AND FAIR HEARING PROCEDURES Providers may appeal adverse determinations by the department through the administrative review and fair hearing procedures specified in ARM 46.12.1268. Authorizing statute(s): Sec. 2-4…

37.88.201 LICENSED CLINICAL SOCIAL WORK SERVICES, DEFINITIONS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; REP, 2018 MAR p. 725, Eff. 5/1/18.

37.88.205 LICENSED CLINICAL SOCIAL WORK SERVICES, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD, 2004 …

37.88.206 LICENSED CLINICAL SOCIAL WORK SERVICES, REIMBURSEMENT Providers must bill for covered services using the procedure codes and modifiers set forth and according to the definitions contained in the CMS's Healthcare Common Procedure Coding System (HCPCS). Information regard…

37.88.301 LICENSED PROFESSIONAL COUNSELOR SERVICES, DEFINITIONS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; REP, 2018 MAR p. 725, Eff. 5/1/18.

37.88.305 LICENSED PROFESSIONAL COUNSELOR SERVICES, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 865; AMD, 200…

37.88.306 LICENSED PROFESSIONAL COUNSELOR SERVICES, REIMBURSEMENT Providers must bill for covered services using the procedure codes and modifiers set forth, and according to the definitions contained, in the CMS's Healthcare Common Procedure Coding System (HCPCS). Information re…

37.88.601 LICENSED PSYCHOLOGIST SERVICES, DEFINITIONS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; REP, 2018 MAR p. 725, Eff. 5/1/18.

37.88.605 LICENSED PSYCHOLOGIST SERVICES, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD, 2004 MAR p. 4…

37.88.606 LICENSED PSYCHOLOGIST SERVICES, REIMBURSEMENT Providers must bill for covered services using the procedure codes and modifiers set forth and according to the definitions contained in the CMS's Healthcare Common Procedure Coding System (HCPCS). Information regarding bill…

37.88.901 MENTAL HEALTH CENTER SERVICES FOR ADULTS, DEFINITIONS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD, 2001…

37.88.903 MENTAL HEALTH CENTER SERVICES FOR ADULTS, DEFINED (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, MCA History: NEW, 2009 MAR p. 1489, Eff. 8/28/09; REP, 2018 MAR p. 725, Eff. 5/1/18.

37.88.905 MENTAL HEALTH CENTER SERVICES FOR ADULTS, REQUIREMENTS These requirements are in addition to those requirements contained in rules generally applicable to Medicaid providers. Mental health center services may be provided only by a facility that is licensed as a mental h…

37.88.906 MENTAL HEALTH CENTER SERVICES FOR ADULTS, COVERED SERVICES (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD,…

37.88.907 MENTAL HEALTH CENTER SERVICES FOR ADULTS, REIMBURSEMENT The department adopts and incorporates by reference the Medicaid Adult Mental Health fee schedule as provided in ARM 37.85.105(5). A copy of the department's fee schedule is posted at the Montana Medicaid provider …

37.88.908 MENTAL HEALTH CENTER SERVICES FOR ADULTS, PROGRAM OF ASSERTIVE COMMUNITY TREATMENT (PACT) (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, MCA History: NEW, 2009 MAR p. 1489, Eff. 8/28/09; AMD, 2012 MAR p.…

37.88.909 MENTAL HEALTH CENTER SERVICES FOR ADULTS, INTENSIVE COMMUNITY-BASED REHABILITATION FACILITY (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, MCA History: NEW, 2009 MAR p. 1489, Eff. 8/28/09; REP, 2018 MAR …

37.88.910 RESIDENTIAL PSYCHIATRIC CARE OUTSIDE MONTANA (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, MCA Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA History: NEW, 2004 MAR p. 482, Eff. 2/27/04; REP, 2011 MAR p. 1154, Eff. 6/24/11.

37.89.1001 CRISIS DIVERSION GRANTS, PURPOSE Crisis Diversion Grants, as provided under Title 53, chapter 21, part 12, MCA, provide funding to eligible county and federally recognized tribal governments to support the implementation of community-based jail diversion, crisis interv…

37.89.1003 CRISIS DIVERSION GRANTS, APPLICATION AND PARTICIPANTS At the beginning of the program's funding cycle, the department will issue a request for proposal (RFP) describing the program requirements, evaluation criteria, and eligibility criteria for award of Crisis Diversio…

37.89.1005 CRISIS DIVERSION GRANTS, DETERMINING GRANT AMOUNTS The department will baseCrisis Diversion Grants awarded under this subchapter on the criteria specified in 53-21-1203, MCA. The total amount of Crisis Diversion Grants will not exceed available funding. For each county…

37.89.1007 CRISIS DIVERSION GRANTS, DISTRIBUTION If the amount requested forCrisis Diversion Grants exceeds the funding available, the department shall allocate available funding based on a percentage of the total points awarded to an applicant. Points will be awarded by an evalu…

37.89.1009 CRISIS DIVERSION GRANTS, STRATEGIC PLAN REQUIREMENTS Successful grant applicants will be those submitting a grant application with at least the following elements: a jail diversion and crisis intervention strategic plan, which mustinclude a plan for community-based or …

37.89.1021 JAIL DIVERSION AND CRISIS INTERVENTION, CONTRACTS FOR PSYCHIATRIC TREATMENT BEDS The department may contract with a mental health facility for psychiatric treatment beds as provided for in 53-21-1204, MCA, to the extent of available funding. Contracts will be developed…

37.89.1025 CONTRACTS FOR PAYMENT OF SHORT-TERM INPATIENT TREATMENT The department may contract with eligible providers for payment for short-term inpatient treatment to eligible patients as provided in 53-21-1205 and 53-21-1206, MCA, to the extent of available funding. Eligible p…

37.89.103 MENTAL HEALTH SERVICES PLAN, DEFINITIONS (REPEALED) Authorizing statute(s): 41-3-1103, 52-1-103, 53-2-201, 53-6-113, 53-6-131, 53-6-701, 53-21-703, MCA Implementing statute(s): 41-3-1103, 52-1-103, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53…

37.89.106 MENTAL HEALTH SERVICES PLAN, MEMBER ELIGIBILITY (REPEALED) Authorizing statute(s): 41-3-1103, 52-2-603, 53-2-201, 53-6-113, 53-6-131, 53-6-701, 53-6-706, 53-21-703, MCA Implementing statute(s): 41-3-1103, 52-2-603, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-101, 53-6-…

37.89.112 MENTAL HEALTH SERVICES PLAN, OUTPATIENT DRUGS FOR BENEFICIARIES ELIGIBLE FOR MEDICARE (REPEALED) Authorizing statute(s): 53-2-201, MCA Implementing statute(s): 53-21-701, MCA History: NEW, 2006 MAR p. 1053, Eff. 4/21/06; REP, 2022 MAR p. 1882, Eff. 9/24/22.

37.89.114 MENTAL HEALTH SERVICES PLAN, COVERED SERVICES (REPEALED) Authorizing statute(s): 41-3-1103, 52-1-103, 52-2-603, 53-2-201, 53-6-113, 53-6-131, 53-6-706, 53-21-703, MCA Implementing statute(s): 41-3-1103, 52-1-103, 52-2-603, 53-1-405, 53-1-601, 53-1-602, 53-1-603, 53-2-20…

37.89.115 MENTAL HEALTH SERVICES PLAN, PROVIDER PARTICIPATION (REPEALED) Authorizing statute(s): 2-4-201, 41-3-1103, 53-2-201, 53-6-113, 53-21-703, MCA Implementing statute(s): 2-4-201, 41-3-1103, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-113, 53-6-116, 53-6-701, 53-6-705, 53-…

37.89.118 MENTAL HEALTH SERVICES PLAN, AUTHORIZATION REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-21-703, MCA Implementing statute(s): 53-2-201, 53-21-202, 53-21-701, 53-21-702, MCA History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2001 MAR p. 27; EMER…

37.89.119 MENTAL HEALTH SERVICES PLAN, PREMIUM PAYMENTS, AND MEMBER COPAYMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, 53-6-131, 53-21-703, MCA Implementing statute(s): 53-1-405, 53-1-601, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53-6-131, 53-21-701, 53-21-702, MCA …

37.89.125 MENTAL HEALTH SERVICES PLAN, PROVIDER REIMBURSEMENT (REPEALED) Authorizing statute(s): 53-2-201, 53-6-113, 53-21-703, MCA Implementing statute(s): 53-1-601, 53-2-201, 53-6-101, 53-6-116, 53-6-701, 53-6-705, 53-21-202, 53-21-702, MCA History: NEW, 1997 MAR p. 548, Eff. 3…

37.89.131 MENTAL HEALTH SERVICES PLAN, MEMBER NOTICE, GRIEVANCE AND RECONSIDERATION AND RIGHTS (REPEALED) Authorizing statute(s): 2-4-201, 53-2-201, 53-6-113, 53-6-706, 53-21-703, MCA Implementing statute(s): 2-4-201, 53-1-601, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53-6-706, 53…

37.89.135 MENTAL HEALTH SERVICES PLAN, TRANSITION FROM RULES IN EFFECT PRIOR TO JULY 1, 1999 (REPEALED) Authorizing statute(s): 53-2-201, MCA Implementing statute(s): 53-1-601, 53-1-612, 53-2-201, 53-21-202, MCA History: NEW, 1997 MAR p. 548, Eff. 3/25/97; AMD, 1999 MAR p. 1301, …

37.89.201 NON-MEDICAID MENTAL HEALTH SERVICES FOR ADULTS: REQUIREMENTS In addition to requirements contained in rule, the department has developed and published the Behavioral Health and Developmental Disabilities Division Non-Medicaid Services Provider Manual for Substance Use D…

37.89.501 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: DEFINITIONS (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882, Eff. 9/24/22.

37.89.503 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: LIMITATIONS (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW , 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882, Eff. 9/24/22.

37.89.505 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CRISIS MANAGEMENT SERVICES (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882, Eff…

37.89.507 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CRISIS STABILIZATION PLAN (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882, Eff.…

37.89.509 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CLAIMS AND REIMBURSEMENT (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 2008 MAR p. 1489, Eff. 4/11/08; AMD, 2015 MAR p. 2283, Eff. …

37.89.521 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSABLE SERVICES (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW , 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882, Eff. 9/…

37.89.523 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSEMENT FOR SERVICES (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW, 2008 MAR p. 1489, Eff. 4/11/08; AMD, 2011 MAR p. 1394, Eff…

37.89.525 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSEMENT FOR EXCLUSIONS (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW , 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882, …

37.89.531 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: WHERE SERVICES MAY BE PROVIDED (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW , 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882…

37.89.541 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CONFIDENTIALITY REQUIREMENTS (REPEALED) Authorizing statute(s): 53-6-101, 53-6-113, MCA Implementing statute(s): 53-6-101, MCA History: NEW , 2008 MAR p. 1489, Eff. 4/11/08; REP, 2022 MAR p. 1882, …