(1) Targeted case management services for youth with SED will be reimbursed on a fee per unit of service basis. For purposes of this rule, a unit of service is a period of 15 minutes.

(a) A unit of service is a period of 15 minutes as follows:

(i) one unit of service is greater than or equal to 8 minutes and less than or equal to 23 minutes;

(ii) two units of service are greater than or equal to 24 minutes and less than or equal to 38 minutes;

(iii) three units of service are greater than or equal to 39 minutes and less than or equal to 53 minutes;

(iv) four units of service are greater than or equal to 54 minutes and less than or equal to 68 minutes;

(v) five units of service are greater than or equal to 69 minutes and less than or equal to 83 minutes;

(vi) six units of service are greater than or equal to 84 minutes and less than or equal to 98 minutes;

(vii) seven units of service are greater than or equal to 99 minutes and less than or equal to 113 minutes; and

(viii) eight units of service are greater than or equal to 114 minutes and less than or equal to 128 minutes.

(2) The department will pay providers of targeted case management services for youth with SED the lesser of:

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

(b) the amount specified in the department's Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule, adopted at ARM 37.86.2207. A copy of the fee schedule may be obtained from the Department of Public Health and Human Services, Health Resources Division, Children's Mental Health Bureau, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

(3) Targeted case management services may be billed to the department's fiscal agent using a CMS 1500 claim form. The provider must include the youth's DSM-IV diagnosis code on the claim form.

(4) Case managers may not bill for time spent writing progress notes. This activity is included in the rate for TCM services.

(5) Targeted case management services may be billed whether provided face-to-face or by telephone.