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37.86.5306    TEAM CARE PROGRAM: REIMBURSEMENT

(1) Reimbursement for team care case management services is $6.00 a month for each enrollee.

(2) A provider may be reimbursed for team care case management for an enrollee for a month during which case management or medical care was not provided to the enrollee if the primary care provider is otherwise in compliance with the agreement with the program.

(3) Medicaid services authorized or provided by a primary care provider are reimbursed as provided in ARM Title 37, chapters 40, 82, 83, 85, 86 and 88.

(4) Services listed in ARM 37.86.5110(1) provided to enrollees are not reimbursable unless provided or authorized by an enrollee's primary care provider in accordance with these rules.

History: Sec. 53-6-113, MCA; IMP, Sec. 53-6-104 and 53-6-113, MCA; NEW, 2004 MAR p. 1624, Eff. 7/23/04.

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