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37.88.1125    INPATIENT PSYCHIATRIC HOSPITALS, REIMBURSEMENT

(1) For inpatient psychiatric services provided by inpatient psychiatric hospital facilities located in the state of Montana, the Montana Medicaid program will pay a provider according to the diagnosis related groups (DRG) prospective payment system described in ARM 37.86.2905. In addition to the prospective DRG rate, providers will be reimbursed for the following:

(a) capital-related costs;

(b) cost or day outliers;

(c) catastrophic case payments;

(d) disproportionate share hospital (DSH) payments and supplemental DSH payments; and

(e) hospital reimbursement adjustor payments.

(2) Inpatient psychiatric hospital facilities will not be reimbursed for inpatient psychiatric services in addition to the prospective DRG rate for medical education costs, certified registered nurse anesthetist costs or other costs or components.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA; NEW, 2004 MAR p. 1328, Eff. 6/4/04.

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