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This is an obsolete version of the rule. Please click on the rule number to view the current version.

24.29.1521    MEDICAL EQUIPMENT AND SUPPLIES

(1) Reimbursement for medical equipment and supplies dispensed through a medical provider is limited to the lesser of $30.00 or 30 percent above the cost of the item including freight, except prescription medicines are limited to charges allowed under 39-71-727 , MCA. An invoice documenting the cost of the equipment or supply must be sent to the insurer upon the insurer's request.

(2) If a provider adds value to medical equipment or supplies (such as by complex assembly, modification, or special fabrication) then the provider may charge a reasonable fee for those services. Merely unpacking an item is not a "value-added" service. While extensive fitting of devices may be billed for, simple fitting (such as adjusting the height of crutches) is not billable.

(3) This rule does not apply to:

(a) equipment supply houses that are not also health care providers;

(b) hospitals; or

(c) pharmacies.

 

History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 1993 MAR p. 404, Eff. 4/1/93; AMD, 2007 MAR p. 260, Eff. 2/23/07.

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