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Rule: 24.29.1538 Prev     Up     Next    
Rule Title: CONVERSION FACTORS FOR SERVICES PROVIDED ON OR AFTER JANUARY 1, 2008
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Department: LABOR AND INDUSTRY
Chapter: WORKERS' COMPENSATION AND OCCUPATIONAL DISEASE
Subchapter: Nonfacility Service Rules
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

Printer Friendly Version

24.29.1538    CONVERSION FACTORS FOR SERVICES PROVIDED ON OR AFTER JANUARY 1, 2008

(1) This rule applies to services, supplies, and equipment provided on or after January 1, 2008.

(2) The conversion factors established by the department for goods and services, other than anesthesia services are:

(a) $60.47 on or after July 1, 2023.

(b) All prior conversion factors for services provided starting July 1, 2013, are available on the department's website. A copy of the conversion factors for services provided starting July 1, 2013, may be requested by email at DLIERDBP&S@mt.gov; phone at 406-444-6543; or by mail at P.O. Box 8011 Helena, MT 59604.

(3) The conversion factors established by the department for anesthesia services are:

(a) $65.73 on or after July 1, 2023.

(b) All prior conversion factors for services provided starting July 1, 2013, are available on the department's website. A copy of the conversion factors for services provided starting July 1, 2013, through the present may be requested by email at DLIERDBP&S@mt.gov; phone at 406-444-6543; or by mail at P.O. Box 8011 Helena, MT 59604.

(4) Up to the top five insurers or third-party administrators, ranked by premiums written in Montana providing group health insurance coverage through a group health plan as defined in 33-22-140, MCA, and who use the RBRVS to determine fees for covered services, must annually provide to the department their current standard conversion factors by July 1.

(5) The conversion factor amounts for professional services are calculated using the average rates for medical services paid by up to the top five insurers or third-party administrators providing group health insurance via a group health plan in Montana, based upon the amount of premium for that category of insurance reported to the office of the Montana insurance commissioner. The term "group health plan" has the same meaning as provided by 33-22-140, MCA. To be included in the conversion factor determination, the insurer or third-party administrator must occupy at least one percent of the market share for group health insurance policies as reported annually to the insurance commissioner.

(a) The department annually surveys up to the top five insurers to collect information on the rates (the RBRVS conversion factors) paid during the current year for professional health care services furnished in Montana.

(b) The department's conversion factors for the following year are set at no more than 110 percent of the surveyed average. 

 

History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17; AMD, 2018 MAR p. 1036, Eff. 5/26/18; AMD, 2019 MAR p. 848, Eff. 6/22/19; AMD, 2020 MAR p. 1021, Eff. 6/13/20; AMD, 2021 MAR p. 716, Eff. 6/12/21; AMD, 2022 MAR p. 1075, Eff. 6/25/22; AMD, 2023 MAR p. 522, Eff. 6/10/23.


 

 
MAR Notices Effective From Effective To History Notes
24-29-399 6/10/2023 Current History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17; AMD, 2018 MAR p. 1036, Eff. 5/26/18; AMD, 2019 MAR p. 848, Eff. 6/22/19; AMD, 2020 MAR p. 1021, Eff. 6/13/20; AMD, 2021 MAR p. 716, Eff. 6/12/21; AMD, 2022 MAR p. 1075, Eff. 6/25/22; AMD, 2023 MAR p. 522, Eff. 6/10/23.
24-29-392 6/25/2022 6/10/2023 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17; AMD, 2018 MAR p. 1036, Eff. 5/26/18; AMD, 2019 MAR p. 848, Eff. 6/22/19; AMD, 2020 MAR p. 1021, Eff. 6/13/20; AMD, 2021 MAR p. 716, Eff. 6/12/21; AMD, 2022 MAR p. 1075, Eff. 6/25/22.
24-29-367 6/12/2021 6/25/2022 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17; AMD, 2018 MAR p. 1036, Eff. 5/26/18; AMD, 2019 MAR p. 848, Eff. 6/22/19; AMD, 2020 MAR p. 1021, Eff. 6/13/20; AMD, 2021 MAR p. 716, Eff. 6/12/21.
24-29-354 6/13/2020 6/12/2021 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17; AMD, 2018 MAR p. 1036, Eff. 5/26/18; AMD, 2019 MAR p. 848, Eff. 6/22/19; AMD, 2020 MAR p. 1021, Eff. 6/13/20.
24-29-345 6/22/2019 6/13/2020 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17; AMD, 2018 MAR p. 1036, Eff. 5/26/18; AMD, 2019 MAR p. 848, Eff. 6/22/19.
24-29-335 5/26/2018 6/22/2019 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17; AMD, 2018 MAR p. 1036, Eff. 5/26/18.
24-29-322 6/10/2017 5/26/2018 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16; AMD, 2017 MAR p. 784, Eff. 6/10/17.
24-29-314 6/18/2016 6/10/2017 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15; AMD, 2016 MAR p. 1055, Eff. 6/18/16.
24-29-306 6/26/2015 6/18/2016 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14; AMD, 2015 MAR p. 818, Eff. 6/26/15.
24-29-283 7/11/2014 6/26/2015 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2014 MAR p. 1513, Eff. 7/11/14.
24-29-273 7/12/2013 7/11/2014 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09; AMD, 2013 MAR p. 1185, Eff. 7/12/13.
24-29-240 12/25/2009 7/12/2013 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09; AMD, 2009 MAR p. 2482, Eff. 12/25/09.
24-29-233 1/16/2009 12/25/2009 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07; AMD, 2009 MAR p. 8, Eff. 1/16/09.
24-29-225 10/26/2007 1/16/2009 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 2007 MAR p. 1670, Eff. 10/26/07.
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