(1) Medicaid reimbursement for mental health services shall be the lowest of:

(a) the provider's actual (submitted) charge for the service; or

(b) the rate established in the department's fee schedule. The department adopts and incorporates by reference the department's Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule dated July 1, 2010. A copy of the fee schedule may be obtained from the Department of Public Health and Human Services, Developmental Services Division, Children's Mental Health Bureau, 111 Sanders, P.O. Box 4210, Helena, MT 59604 or at www.mt.medicaid.org.

(2) The department will not reimburse providers for Medicaid services unless the prior authorization and continued authorization requirements in ARM 37.87.903 are met.

(3) The department will not reimburse providers for two services that duplicate one another on the same day. The department adopts and incorporates by reference the Medicaid Mental Health Plan and Mental Health Services Plan for Youth Services Excluded from Simultaneous Reimbursement (Service Matrix) effective July 1, 2010. A copy of the service matrix may be obtained from the department or at www.mt.medicaid.org.