Mont. Admin. R. 37.86.3005 - OUTPATIENT HOSPITAL SERVICES, REIMBURSEMENT
(1) The department will reimburse for
outpatient hospital services and birthing center services compensable under the
Montana Medicaid program as provided in this rule.
(2) Outpatient hospital services that are not
provided by critical access hospitals as defined in ARM
37.86.2901 will be reimbursed
under ARM 37.86.3007,
37.86.3009,
37.86.3016,
37.86.3018,
37.86.3020,
37.86.3025,
37.86.3109, and
37.86.3037 for medically necessary
services.
(3) Birthing center
services as defined in ARM
37.86.3001 will be reimbursed
under ARM 37.86.3007, 37.86.3016, 37.86.3018, and 37.86.3020, for medically
necessary services.
(4) For
critical access hospitals, interim reimbursement for outpatient hospital
services is based on hospital-specific Medicaid outpatient cost-to-charge
ratio, not to exceed 100%. Critical access hospitals will be reimbursed their
actual allowable costs determined according to ARM
37.86.2803.
Notes
53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, 53-6-113, 53-6-141, MCA;
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