(1) In order to be reimbursed for SUD facility-based treatment services, a SUD facility must be state approved and licensed pursuant to ARM Title 37, chapter 106, subchapter 14.

(2) In order to become state approved, the SUD facility provider must complete and submit the designated application to the department. The SUD facility must be licensed for the level(s) of care indicated in the application.

(3) If the application and supporting documentation do not meet the application requirements, the department will notify the applicant in writing identifying the incomplete or missing information within 30 days of receipt of the application.

(a) The applicant has 30 days from the date of notification to respond in writing to the content of the notice.

(b) If the response is not received within 30 days, the department will deny approval and will notify the applicant in writing of the denial.

(4) If the application and supporting documentation meet the application requirements, the department shall issue full approval. Documentation must include evidence of an active facility license.

(5) The department shall issue a final approval or deny the application and shall send written notification of full approval or denial to the applicant.

(6) The department will reimburse a state approved facility for SUD facility-based services, as outlined in the BHDD Medicaid Manual, using appropriate Common Procedural Terminology (CPT) codes and Healthcare Common Procedure Coding System (HCPCS) codes on applicable department fee schedules.

(7) The department will inspect the facility once every two years, on-site or remotely, to ensure the facility continues to meet the requirements of this rule.

(8) The provider must submit the requested documentation to the department or allow the department access to the provider's premises for inspection.

(9) Approved facilities must follow the ASAM Criteria in the provision of services and adhere to requirements outlined in the BHDD Medicaid Manual.


History: 53-24-204, 53-24-208, MCA; IMP, 53-24-208, MCA; TRANS, C. 207, L. 1975, Eff. 1/2/77; AMD, 1981 MAR p. 1899, Eff. 1/1/82; AMD, 1983 MAR p. 1463, Eff. 10/14/83; AMD, 1987 MAR p. 2383, Eff. 12/25/87; TRANS, from DOC, 1998 MAR p. 1502; AMD, 2022 MAR p. 57, Eff. 1/15/22; AMD, 2022 MAR p. 1889, Eff. 9/24/22.