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Rule Title: RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS, VISITS AND ENCOUNTERS
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Department: PUBLIC HEALTH AND HUMAN SERVICES
Chapter: MEDICAID PRIMARY CARE SERVICES
Subchapter: Rural Health Clinics and Federally Qualified Health Centers
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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37.86.4402    RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS, VISITS AND ENCOUNTERS

(1) A visit is a face-to-face encounter between an RHC or FQHC patient and an RHC or FQHC health professional for the purpose of providing RHC or FQHC services. Reimbursement is available for one encounter per day per eligible member unless it is necessary for the member:

(a) to be seen by different health professionals with different specialties; or

(b) to be seen multiple times per day due to unrelated diagnoses.

(2) Encounters with the same primary diagnosis are not considered separately billable visits, regardless of the health professional providing the service.

 

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA; NEW, 2005 MAR p. 975, Eff. 6/17/05; AMD, 2019 MAR p. 1866, Eff. 10/19/19.


 

 
MAR Notices Effective From Effective To History Notes
37-877 10/19/2019 Current History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA; NEW, 2005 MAR p. 975, Eff. 6/17/05; AMD, 2019 MAR p. 1866, Eff. 10/19/19.
6/17/2005 10/19/2019 History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-2-201, 53-6-101, 53-6-111 and 53-6-113, MCA; NEW, 2005 MAR p. 975, Eff. 6/17/05.
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