1. (1) Psychiatric residential treatment facility (PRTF) assessment services are provided by in-state PRTF facilities and must comply with the requirements of this subchapter and the applicable federal regulations for PRTF services.

2. (2) PRTF assessment services:

   1. (a) require prior authorization by the department or its designee;
   2. (b) are short-term lengths of stay, 14 days or less;
   3. (c) are reimbursed 15% higher than the department's current Medicaid Youth Mental Health Fee Schedule for PRTF Services.

3. (3) Assessment services include the following, as clinically indicated:

   1. (a) diagnostic and functional assessment;
   2. (b) medication evaluation;
   3. (c) psychological and IQ testing;
   4. (d) substance use disorder assessment; and
   5. (e) supported group or independent living needs assessment.
4. (4) Assessment services include a written report within 14 days after the discharge that includes clear recommendations for treatment of the youth.

5. (5) If the PRTF admission continues beyond the assessment period and becomes a regular admission, the department will not reimburse at the higher rate for assessment services.

   1. (a) If the youth is re-admitted to the facility within 30 days of the assessment, the admission for assessment may be subject to department review and full recovery.

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

Implementing statute(s): 53-2-201, 53-6-101, 53-6-111, MCA

History: NEW, 2008 MAR p. 2360, Eff. 1/1/09; AMD, 2015 MAR p. 2147, Eff. 12/11/15.