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37.88.905    MENTAL HEALTH CENTER SERVICES, REQUIREMENTS

(1) These requirements are in addition to those requirements contained in rules generally applicable to Medicaid providers.

(2) Mental health center services may be provided only by a facility which is licensed as a mental health center by the department in accordance with the provisions of Title 50, chapter 5, part 2, MCA, and implementing administrative rules.

(3) Mental health center services must be provided by, or under the direction of a licensed physician.

(4) Mental health center services must be available to recipients continuously throughout the year.

(5) Mental health center services must be provided to a recipient in accordance with an individualized treatment plan developed and maintained in accordance with license requirements.

(6) In addition to the clinical records required by mental health center license rules, the provider must maintain for day treatment services the records required by ARM 37.85.414, which shall include but are not limited to documentation of the recipient's attendance for the required period of time for the service billed and entry of progress notes in the recipient's record at least every 30 days and upon any significant change in the recipient's condition.

(7) For purposes of Medicaid billing and reimbursement of day treatment services, a half day requires that the recipient has attended the day treatment program for a minimum of two hours during the treatment day.

(8) For purposes of meeting the minimum hours required in (7) , the provider may not include time during which the recipient is receiving practitioner services which are actually billed separately as practitioner services as permitted under ARM 37.88.906, up to a maximum of four hours during the treatment day.

(9) Services billed as community-based psychiatric rehabilitation and support may not be counted toward the time requirements for any other service or billed by the provider as any other type or category of service.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA; NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD, 2001 MAR p. 27, Eff. 1/12/01; AMD, 2002 MAR p. 2225, Eff. 8/16/02.

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