Admin. R. Mont. 37.88.306
Licensed Professional Counselor Services, Reimbursement (Repealed)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, 53-21-201, 53-21-202, 53-21-701, 53-21-702, MCAState of Montana
37.88.306 LICENSED PROFESSIONAL COUNSELOR 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 professional counselor 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, 53-21-201, 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. 865; 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.