37.87.1401 HOME SUPPORT SERVICES AND THERAPEUTIC FOSTER CARE, SERVICES REIMBURSEMENT
(1) Reimbursement for the therapeutic portion of home support services (HSS) and therapeutic foster care (TFC) services is the lesser of:
(a) the amount specified in the department's fee schedule adopted in ARM 37.85.105; or
(b) the provider's usual and customary charges.
(2) HSS and TFC providers must use the procedure codes designated by the department, in the fee schedule referred to in (1)(a) to be reimbursed for HSS and TFC.
(3) HSS and TFC providers are reimbursed a daily rate.
(a) To receive the daily rate for HHS, the provider must have contact as described in ARM 37.87.1410(6). The department will not reimburse the daily rate for any telephone contacts that exceed the number of face-to-face contacts reimbursed in a four-week period. Reimbursement is limited to one contact per day.
(b) For TFC services, the department will reimburse providers the daily rate for every day of a four-week period if the provider meets the minimum number of contacts as described in ARM 37.87.1410(6) during the four-week period.
(4) Medicaid will not reimburse for room, board, maintenance, or any other nontherapeutic component of HSS or TFC treatment, including when this service is delivered in a foster home.
History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, MCA; NEW, 2013 MAR p. 166, Eff. 2/1/13; AMD, 2013 MAR p. 2153, Eff. 11/15/13; AMD, 2018 MAR p. 458, Eff. 3/1/18.