Admin. R. Mont. 37.88.206
Licensed Clinical Social Work Services, Reimbursement (Repealed)
Effective Mar 1, 2018Authorizing statute(s): 53-2-201, 53-6-113, 53-21-703 MCA; Implementing statute(s): 53-1-601, 53-1-602, 53-1-603, 53-6-101, 53-6-113, 53-21-202, 53-21-701, 53-21-702, MCAState of Montana
37.88.206 LICENSED CLINICAL SOCIAL WORK SERVICES, REIMBURSEMENT
- (1) Providers must bill for covered services using the procedure codes and modifiers set forth and according to the definitions contained in the CMS's Healthcare Common Procedure Coding System (HCPCS). Information regarding billing codes, modifiers, and HCPCS is available upon request from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.
(2) Subject to the requirements of this rule, the Montana Medicaid program pays the following for licensed clinical social worker services:
(a) For patients who are eligible for Medicaid, the lower of:
- (i) the provider's usual and customary charge for the service; or
- (ii) the amount specified in the department's Medicaid Mental Health Fee Schedule.
Authorizing statute(s): 53-2-201, 53-6-113, 53-21-703 MCA
Implementing statute(s): 53-1-601, 53-1-602, 53-1-603, 53-6-101, 53-6-113, 53-21-202, 53-21-701, 53-21-702, MCA
History: NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD, 2001 MAR p. 1476, Eff. 8/10/01; AMD, 2001 MAR p. 2156, Eff. 10/26/01; AMD, 2006 MAR p. 3078, Eff. 1/1/07; AMD, 2008 MAR p. 1988, Eff. 9/12/08; AMD, 2018 MAR p. 458, Eff. 3/1/18.