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Rule Title: TARGETED CASE MANAGEMENT SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE, REIMBURSEMENT
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Department: PUBLIC HEALTH AND HUMAN SERVICES
Chapter: CHILDREN'S MENTAL HEALTH SERVICES
Subchapter: Targeted Case Management Services for Youth With Serious Emotional Disturbance
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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37.87.809    TARGETED CASE MANAGEMENT SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE, REIMBURSEMENT

(1) Targeted case management (TCM) 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 based on a 15-minute unit increment. A unit of service is a period of 15 minutes as follows:

(a) one unit of service is equal to 8 minutes but less than 23 minutes;

(b) two units of service are greater than or equal to 23 minutes but less than 38 minutes;

(c) three units of service are greater than or equal to 38 minutes but less than 53 minutes;

(d) four units of service are greater than or equal to 53 minutes but less than 68 minutes;

(e) five units of service are greater than or equal to 68 minutes but less than 83 minutes;

(f) six units of service are greater than or equal to 83 minutes but less than 98 minutes;

(g) seven units of service are greater than or equal to 98 minutes but less than 113 minutes; and

(h) eight units of service are greater than or equal to 113 minutes but less than 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 rate established in the department's Medicaid fee schedule, as adopted in ARM 37.85.105.

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

(4) TCM services may be billed whether provided face-to-face or by telephone.

 

History: 53-2-201, 53-6-113, MCA; IMP, 53-1-601, 53-1-602, 53-1-603, 53-2-201, MCA; NEW, 2009 MAR p. 266, Eff. 2/27/09; AMD, 2010 MAR p. 1512, Eff. 7/1/10; AMD, 2012 MAR p. 1273, Eff. 7/1/12; AMD, 2013 MAR p. 2153, Eff. 11/15/13; AMD, 2016 MAR p. 2063, Eff. 11/11/16.


 

 
MAR Notices Effective From Effective To History Notes
37-767 11/11/2016 Current History: 53-2-201, 53-6-113, MCA; IMP, 53-1-601, 53-1-602, 53-1-603, 53-2-201, MCA; NEW, 2009 MAR p. 266, Eff. 2/27/09; AMD, 2010 MAR p. 1512, Eff. 7/1/10; AMD, 2012 MAR p. 1273, Eff. 7/1/12; AMD, 2013 MAR p. 2153, Eff. 11/15/13; AMD, 2016 MAR p. 2063, Eff. 11/11/16.
37-648 11/15/2013 11/11/2016 History: 53-2-201, 53-6-113, MCA; IMP, 53-1-601, 53-1-602, 53-1-603, 53-2-201, MCA; NEW, 2009 MAR p. 266, Eff. 2/27/09; AMD, 2010 MAR p. 1512, Eff. 7/1/10; AMD, 2012 MAR p. 1273, Eff. 7/1/12; AMD, 2013 MAR p. 2153, Eff. 11/15/13
37-584 7/1/2012 11/15/2013 History: 53-2-201, 53-6-113, MCA; IMP, 53-1-601, 53-1-602, 53-1-603, 53-2-201, MCA; NEW, 2009 MAR p. 266, Eff. 2/27/09; AMD, 2010 MAR p. 1512, Eff. 7/1/10; AMD, 2012 MAR p. 1273, Eff. 7/1/12.
37-503 7/1/2010 7/1/2012 History: 53-2-201, 53-6-113, MCA; IMP, 53-1-601, 53-1-602, 53-1-603, 53-2-201, MCA; NEW, 2009 MAR p. 266, Eff. 2/27/09; AMD, 2010 MAR p. 1512, Eff. 7/1/10.
37-460 2/27/2009 7/1/2010 History: 53-2-201, 53-6-113, MCA; IMP, 53-1-601, 53-1-602, 53-1-603, 53-2-201, MCA; NEW, 2009 MAR p. 266, Eff. 2/27/09.
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