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

37.87.1215    PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY SERVICES, ASSESSMENT SERVICES

(1) PRTF assessment services are provided by in-state facilities and must comply with the requirements of this subchapter and the applicable federal regulations for PRTF services.

(2) PRTF assessment services:

(a) require prior authorization by the department or its designee;

(b) are short-term lengths of stay, 14 days or less;

(c) are reimbursed 15% higher than the department's current Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule for PRTF services.

(3) Assessment services include the following, as clinically indicated:

(a) diagnostic and functional assessment;

(b) medication evaluation;

(c) psychological and IQ testing;

(d) chemical dependency assessment; and

(e) supported group or independent living needs assessment.

(4) Assessment services include a written report within 14 days after the discharge that includes clear recommendations for treatment of the youth.

(5) If the PRTF admission continues beyond the assessment period and becomes a regular admission, the department will not reimburse at the higher rate for assessment services.

(a) If the youth is re-admitted to the facility within 30 days of the assessment, the admission for assessment may be subject to department review and full recovery.

(6) Assessment services must be provided by qualified staff or contractors operating within the scope of their practice.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, MCA; NEW, 2008 MAR p. 2360, Eff. 1/1/09.

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