PUBLIC HEALTH AND HUMAN SERVICES
37.86 - medicaid primary care services
37.86.101
physician services, definitions
37.86.104
physician services, requirements
37.86.105
physician services, reimbursement/general requirements and modifiers
37.86.108
mental health services plan, application forms, income verification
37.86.110
mental health services plan, eligibility redeterminations, members required to notify department of changes, repayment of benefits
37.86.112
mental health services plan, emergency mental health services, liability for failure to complete application
37.86.201
mid-level practitioner services, requirements
37.86.202
mid-level practitioner services, definitions
37.86.205
mid-level practitioner services, requirements and reimbursement
37.86.501
podiatry services, definitions
37.86.505
podiatry services, requirements
37.86.506
podiatry services, reimbursement
37.86.601
therapy services, definitions
37.86.605
therapy services, provider requirements
37.86.606
therapy services, service requirements and restrictions
37.86.610
therapies, reimbursement
37.86.701
audiology services, provider requirements
37.86.702
audiology services, service requirements, and restrictions
37.86.705
audiology services, reimbursement
37.86.801
hearing aid services, definitions
37.86.802
hearing aid services, requirements, and limitations
37.86.805
hearing aid services, reimbursement
37.86.805
hearing aid services, reimbursement
37.86.901
collaborative practice drug therapy management - definitions
37.86.902
collaborative practice drug therapy management - requirements and eligibility
37.86.905
collaborative practice drug therapy management - reimbursement
37.86.1001
dental services, definitions
37.86.1002
dental services, requirements
37.86.1004
reimbursement methodology for resource based relative value for dentists (rvd)
37.86.1005
dental services, reimbursement
37.86.1006
dental services, covered procedures
37.86.1101
outpatient drugs, definitions
37.86.1102
outpatient drugs, requirements
37.86.1103
outpatient drugs, fraud, waste, and abuse
37.86.1105
outpatient drugs, reimbursement
37.86.1106
calculation of the average acquisition cost
37.86.1111
opportunity for hearing
37.86.1201
licensed direct-entry midwife
37.86.1401
clinic services, definitions
37.86.1402
clinic services, requirements
37.86.1405
clinic services, covered procedures
37.86.1406
clinic services, reimbursement
37.86.1501
home infusion therapy services, definitions
37.86.1502
home infusion therapy services, provider requirements
37.86.1505
home infusion therapy services, requirements
37.86.1506
home infusion therapy services, reimbursement
37.86.1701
family planning services
37.86.1705
family planning services, requirements
37.86.1706
family planning services, reimbursement
37.86.1801
prosthetic devices, durable medical equipment, and medical supplies, definitions
37.86.1802
prosthetic devices, durable medical equipment, and medical supplies, general requirements
37.86.1806
prosthetic devices, durable medical equipment, and medical supplies, reimbursement requirements
37.86.1807
prosthetic devices, durable medical equipment, and medical supplies, fee schedule
37.86.1807
prosthetic devices, durable medical equipment, and medical supplies, fee schedule
37.86.2001
optometric services, definitions
37.86.2002
optometric services, requirements
37.86.2005
optometric services, reimbursement
37.86.2101
eyeglasses, definitions
37.86.2102
eyeglasses, services, requirements and restrictions
37.86.2105
eyeglasses, reimbursement
37.86.2201
early and periodic screening, diagnostic and treatment services (epsdt) , purpose, eligibility, and scope
37.86.2205
early and periodic screening, diagnostic and treatment services (epsdt) , required screening and preventive services
37.86.2206
early and periodic screening, diagnostic and treatment services (epsdt) , medical and other services
37.86.2207
early and periodic screening, diagnostic and treatment (epsdt) services, reimbursement
37.86.2207
early and periodic screening, diagnostic, and treatment services (epsdt), reimbursement
37.86.2207
early and periodic screening, diagnostic and treatment (epsdt) services, reimbursement
37.86.2209
early and periodic screening, diagnostic and treatment services (epsdt) , nutrition services
37.86.2211
early and periodic screening, diagnostic and treatment services (epsdt) , chiropractic services
37.86.2213
early and periodic screening, diagnostic and treatment services (epsdt) , outpatient chemical dependency treatment services
37.86.2217
early and periodic screening, diagnostic and treatment services (epsdt), private duty nursing services
37.86.2219
early and periodic screening, diagnostic and treatment services (epsdt) , therapeutic youth group home services
37.86.2221
early and periodic screening, diagnostic and treatment services (epsdt) , therapeutic family care treatment services
37.86.2224
early and periodic screening, diagnostic, and treatment service (epsdt), comprehensive school and community treatment
37.86.2225
early and periodic screening, diagnostic and treatment services (epsdt), csct program billing
37.86.2230
early and periodic screening, diagnostic and treatment services (epsdt), school-based health related services
37.86.2231
early and periodic screening, diagnostic and treatment services (epsdt) , eligibility and scope of school based health related services
37.86.2232
early and periodic screening, diagnostic and treatment services (epsdt) , school based personal care paraprofessional services
37.86.2233
early and periodic screening, diagnostic and treatment services (epsdt) , school psychologist services
37.86.2234
early and periodic screening, diagnostic and treatment services (epsdt) , school-based specialized transportation services
37.86.2235
early and periodic screening, diagnostic and treatment services (epsdt), orientation and mobility specialist services
37.86.2401
transportation and per diem, definitions
37.86.2402
transportation and per diem, requirements
37.86.2405
transportation and per diem, reimbursement
37.86.2501
specialized nonemergency medical transportation, definitions
37.86.2502
specialized nonemergency medical transportation, requirements
37.86.2505
specialized nonemergency medical transportation, reimbursement
37.86.2601
ambulance services, definitions
37.86.2602
ambulance services, requirements
37.86.2604
ambulance services, coverage and billable services
37.86.2605
ambulance services, reimbursement
37.86.2606
ambulance services, qualified rate adjustment, payment eligibility and computation
37.86.2801
all hospital reimbursement, general
37.86.2803
all hospital reimbursement, cost reporting
37.86.2806
cost-based hospital, general reimbursement
37.86.2810
inpatient and outpatient hospital services, qualified rate adjustment payment, eligibility, and computation
37.86.2820
desk reviews, overpayments, and underpayments
37.86.2901
inpatient hospital services, definitions
37.86.2902
inpatient hospital services, requirements
37.86.2903
inpatient hospital services, exclusions
37.86.2904
inpatient hospital services, billing requirements
37.86.2905
inpatient hospital services, general reimbursement
37.86.2907
inpatient hospital prospective reimbursement, apr-drg payment rate determination
37.86.2910
inpatient hospital reimbursement, qualified rate adjustment payment
37.86.2912
inpatient hospital prospective reimbursement, capital-related costs
37.86.2914
inpatient hospital prospective reimbursement, medical education costs
37.86.2916
inpatient hospital prospective reimbursement, cost outliers
37.86.2918
inpatient hospital, readmissions, partial eligibility, outpatient bundling, and transfers for prospective payment system (pps) facilities
37.86.2920
inpatient hospital prospective reimbursement, hospital residents
37.86.2921
hospital residency requirements
37.86.2924
inpatient hospital cost based reimbursement, certified registered nurse anesthetists
37.86.2925
inpatient hospital reimbursement, disproportionate share hospital (dsh) payments
37.86.2928
inpatient hospital reimbursement, hospital reimbursement adjustor
37.86.2931
routine disproportionate share hospital
37.86.2932
medicaid utilization rate
37.86.2935
calculating low income utilization rate, for routine disproportionate share hospitals
37.86.2940
hospital reimbursement adjustor (hra), data sources
37.86.2943
border hospital reimbursement
37.86.2947
out-of-state hospital and centers of excellence reimbursement
37.86.2950
graduate medical education payment program
37.86.3001
outpatient hospital services, definitions
37.86.3002
outpatient hospital services, scope and requirements
37.86.3003
outpatient hospital services, exclusions
37.86.3005
outpatient hospital services, reimbursement
37.86.3006
mental health outpatient partial hospital services, requirements
37.86.3007
outpatient hospital services, prospective payment methodology, clinical diagnostic laboratory services
37.86.3009
outpatient hospital services, payment methodology, emergency visit services
37.86.3011
outpatient hospital services, prospective payment methodology, nonemergent emergency room services
37.86.3014
outpatient hospital services, prospective payment methodology, dialysis services
37.86.3015
outpatient hospital reimbursement, outpatient hospital reimbursement adjustor
37.86.3016
outpatient hospital services, prospective payment methodology, imaging services
37.86.3018
outpatient hospital services, prospective payment methodology, other diagnostic services
37.86.3020
outpatient hospital services, outpatient prospective payment system (opps) methodology, ambulatory payment classification
37.86.3022
outpatient hospital services, partial hospitalization services
37.86.3025
outpatient hospital services, reimbursement for services not paid under the ambulatory payment classification system
37.86.3031
provider based entity services, general
37.86.3033
provider-based entity services, recipient access and notification
37.86.3035
provider based entity services, compliance, and penalties
37.86.3037
provider-based entity services, reimbursement
37.86.3101
outpatient hospital services, cardiac and pulmonary rehabilitation services
37.86.3103
outpatient hospital services, cardiac rehabilitation services
37.86.3105
outpatient hospital services, pulmonary rehabilitation services
37.86.3107
outpatient hospital services, cardiac and pulmonary rehabilitation, waiver of service limitations
37.86.3109
outpatient cardiac and pulmonary rehabilitation reimbursement
37.86.3201
nonhospital laboratory and radiology (x-ray) services, requirements
37.86.3205
nonhospital laboratory and radiology (x-ray) services, reimbursement
37.86.3301
case management services, general definitions
37.86.3305
case management services, general provisions
37.86.3306
case management services, general eligibility
37.86.3401
targeted case management services for high risk pregnant women, definitions
37.86.3402
targeted case management services for high risk pregnant women, eligibility
37.86.3405
targeted case management services for high risk pregnant women, coverage
37.86.3410
targeted case management services for high risk pregnant women, provider requirements
37.86.3411
case management services for high risk pregnant women, financial records, and reporting
37.86.3415
targeted case management services for high risk pregnant women, reimbursement
37.86.3501
case management services for adults with severe disabling mental illness, definitions
37.86.3502
case management services for adults with severe disabling mental illness, eligibility
37.86.3503
case management services for adults with severe disabling mental illness, severe disabling mental illness
37.86.3505
case management services for adults with severe disabling mental illness, service coverage
37.86.3506
case management services for adults with severe disabling mental illness, service requirements
37.86.3507
case management services for adults with severe disabling mental illness, provider requirements
37.86.3515
targeted case management services for adults with severe disabling mental illness, reimbursement
37.86.3601
case management services for persons age 16 and over with developmental disabilities, definitions
37.86.3602
case management services for persons age 16 and over with developmental disabilities, eligibility
37.86.3605
case management services for persons age 16 and over with developmental disabilities, coverage
37.86.3606
case management services for persons with developmental disabilities, provider requirements
37.86.3607
case management services for persons with developmental disabilities, reimbursement
37.86.3701
case management services for youth with serious emotional disturbance, definitions
37.86.3702
case management services for youth with serious emotional disturbance, eligibility
37.86.3705
case management services for youth with serious emotional disturbance, service coverage
37.86.3706
case management services for youth with serious emotional disturbance, service requirements
37.86.3707
case management services for youth with serious emotional disturbance, provider requirements
37.86.3715
case management services for youth with serious emotional disturbance, reimbursement
37.86.3801
case management services for children at risk of abuse and neglect, definitions
37.86.3805
case management services for children at risk of abuse and neglect, coverage
37.86.3806
medicaid reimbursed case management services for children at risk of abuse and neglect, eligibility
37.86.3810
medicaid reimbursed case management services for children at risk of abuse and neglect, provider requirements
37.86.3811
medicaid reimbursed case management services for children at risk of abuse and neglect, reimbursement
37.86.3901
targeted case management services for children with special health care needs, definitions
37.86.3902
targeted case management services for children with special health care needs, eligibility
37.86.3905
targeted case management services for children with special health care needs, coverage
37.86.3906
targeted case management services for children with special health care needs, provider requirements
37.86.3910
targeted case management services for children with special health care needs, reimbursement
37.86.4001
targeted case management services for substance use disorders, definitions
37.86.4002
targeted case management services for substance use disorders, eligibility
37.86.4005
targeted case management services for substance use disorders, service coverage
37.86.4006
targeted case management services for substance use disorders, service requirements
37.86.4007
targeted case management services for substance use disorders, provider requirements
37.86.4010
targeted case management services for substance use disorders, reimbursement
37.86.4201
dialysis clinics for end stage renal disease, definitions
37.86.4202
dialysis clinics for end stage renal disease, requirements
37.86.4205
dialysis clinics for end stage renal disease, reimbursement
37.86.4401
rural health clinics and federally qualified health centers, definitions
37.86.4402
rural health clinics and federally qualified health centers, visits and encounters
37.86.4405
rural health clinics and federally qualified health centers, provider participation requirements
37.86.4406
rural health clinics and federally qualified health centers, service requirements
37.86.4407
rural health clinics and federally qualified health centers, record keeping and reports
37.86.4408
rural health clinics and federally qualified health centers, requirements for change in scope of service request
37.86.4409
prospective change in scope of service
37.86.4410
retrospective change in scope of service
37.86.4412
rural health clinics and federally qualified health centers, reimbursement
37.86.4413
rural health clinics and federally qualified health centers, establishment of interim payment for new rhc or fqhc
37.86.4414
rural health clinics and federally qualified health centers, supplemental payments in case of managed care
37.86.4420
rural health clinics and federally qualified health centers, alternative payment methodologies
37.86.4501
promising pregnancy care - definitions
37.86.4502
promising pregnancy care - general provisions
37.86.4503
promising pregnancy care - reimbursement
37.86.4701
organ transplantation, definitions
37.86.4705
organ transplantation, requirements
37.86.4706
organ transplantation, reimbursement
37.86.5001
health maintenance organizations: definitions
37.86.5002
health maintenance organizations: recipient eligibility
37.86.5005
health maintenance organizations: enrollment
37.86.5006
health maintenance organizations: disenrollment
37.86.5007
health maintenance organizations: covered services
37.86.5010
health maintenance organizations: contracts for services
37.86.5011
health maintenance organizations: provision of services
37.86.5012
health maintenance organizations: participating providers
37.86.5013
health maintenance organizations: reimbursement of providers
37.86.5014
health maintenance organizations: reimbursement of hmos
37.86.5020
health maintenance organizations: access to services
37.86.5025
health maintenance organizations: grievance procedures
37.86.5026
health maintenance organizations: records and confidentiality
37.86.5027
health maintenance organizations: recipient education
37.86.5035
health maintenance organizations: quality assurance
37.86.5036
health maintenance organizations: third party
37.86.5101
passport to health program: authority
37.86.5102
passport to health program: definitions
37.86.5103
passport to health program: eligibility
37.86.5104
passport to health program: enrollment in the program
37.86.5110
passport to health program: services
37.86.5111
passport to health program: primary care providers requirements
37.86.5112
passport to health program: reimbursement
37.86.5120
passport to health program: fair hearing
37.86.5201
health improvement program: definitions
37.86.5202
health improvement program: general
37.86.5204
criteria for determining medicaid and healthy montana kids plus (hmk plus) eligible individuals managed under the health improvement program
37.86.5205
health improvement program: client eligibility and assignment
37.86.5206
health improvement program: scope of services and reimbursement
37.86.5303
passport to health's team care program
37.86.5306
team care program: reimbursement
37.86.5401
purpose
37.86.5402
definitions
37.86.5403
diabetes and cardiovascular disease prevention services general
37.86.5404
diabetes and cardiovascular disease prevention services reimbursement