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

37.86.805    HEARING AID SERVICES, REIMBURSEMENT

(1) The department will pay the lower of the following for covered hearing aid services and items:

(a) the provider's reasonable usual and customary charge for the service or item;

(b) the amount specified for the particular service or item in the department's fee schedule. The department adopts and incorporates by reference the department's fee schedule dated January 2005 which sets forth the reimbursement rates for hearing aid services. A copy of the department's fee schedule may be obtained from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

(2) The provider may bill Medicaid for a dispensing fee, as specified in the fee schedule adopted in (1)(b), in addition to the invoice price for the purchase of a hearing aid or aids. The dispensing fee covers and includes the initial ordering, fitting, orientation, counseling, two return visits for the services listed, and the insurance for loss or damages covered under a one year warranty.

History: Sec. 53-2-201 and 53_6-113, MCA; IMP, Sec. 53-6-101, 53-6-113 and 53-6-141, MCA; NEW, 1980 MAR p. 973, Eff. 3/14/80; AMD, 1981 MAR p. 559, Eff. 6/12/81; AMD, 1981 MAR p. 1975, Eff. 1/1/82; AMD, 1982 MAR p. 1289, Eff. 7/1/82; AMD, 1988 MAR p. 596, Eff. 3/25/88; AMD, 1989 MAR p. 859, Eff. 6/30/89; AMD, 1990 MAR p. 1326, Eff. 7/13/90; AMD, 1998 MAR p. 2168, Eff. 8/14/98; AMD, 1999 MAR p. 1379, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 481; AMD, 2000 MAR p. 1664 Eff. 6/30/00; AMD, 2002 MAR p. 1779, Eff. 6/28/02; AMD, 2003 MAR p. 1314, Eff. 7/1/03; AMD, 2005 MAR p. 385, Eff. 3/18/05.

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