Admin. R. Mont. 37.85.106 – Medicaid Behavioral Health Targeted Case Management Fee Schedule

(1) The Montana Medicaid Program establishes provider reimbursement rates for medically necessary, covered services based on the estimated demand for services and the legislative appropriation and federal matching funds.
(2) The Department of Public Health and Human Services (department) adopts and incorporates by reference the Medicaid Behavioral Health Targeted Case Management Fee Schedule effective July 1, 2025, for the following programs within the Behavioral Health and Developmental Disabilities Division:
1. (a) Targeted Case Management Services (TCM) for Youth with Serious Emotional Disturbance (SED), as provided in ARM 37.87.901;
2. (b) Targeted Case Management Services for Substance Use Disorders (SUD), as provided in ARM 37.27.905; and
3. (c) Targeted Case Management Services for Adults with Severe Disabling Mental Illness (SDMI), as provided in ARM 37.86.3515.
(3) Copies of the department's current fee schedules are posted at https://medicaidprovider.mt.gov.

Authorizing statute(s): 53-2-201, 53-6-113, MCA

Implementing statute(s): 53-2-201, 53-6-101, 53-6-113, MCA

History: NEW, 2017 MAR p. 2305, Eff. 1/1/18; AMD, 2018 MAR p. 458, Eff. 3/1/18; AMD, 2018 MAR p. 2057, Eff. 10/20/18; AMD, 2019 MAR p. 1061, Eff. 7/6/19; AMD, 2020 MAR p. 691, Eff. 4/18/20; AMD, 2020 MAR p. 1158, Eff. 7/1/20; AMD, 2021 MAR p. 1324, Eff. 10/9/21; AMD, 2022 MAR p. 1078, Eff. 7/1/22; AMD, 2023 MAR p. 1025, Eff. 9/9/23; AMD, 2024 MAR p. 2269, Eff. 9/21/24; AMD, 2026 MAR, Notice No. 2025-152, Eff. 1/10/26.