37.87.1224 PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY (PRTF) SERVICES, CONTINUITY OF CARE PAYMENT
(1) Hospital-based psychiatric residential treatment facilities as defined in ARM 37.87.1207 qualify for a continuity of care payment.
(a) The amount of the continuity of care adjustor payment will be calculated and paid annually.
(b) The amount will be determined by the department according to the following formula: CCA=[M/D]*P:
(i) "CCA" represents the calculated continuity of care payment;
(ii) "M" is the number of Medicaid inpatient residential days provided by the facility for which the continuity of care payment is being calculated;
(iii) "D" is the total number of Medicaid inpatient residential days provided by all eligible facilities; and
(iv) "P" is the total amount available for distribution via the continuity of care payments. P equals 4% of the revenue generated by the Montana inpatient hospital utilization fee, plus federal financial participation.
(2) The number of Medicaid days must be from the department's paid claims data for the most recent calendar year.