ARM 37.86.1004. REIMBURSEMENT METHODOLOGY FOR SOURCE BASED RELATIVE VALUE FOR DENTISTS

(1) For procedures listed in the relative values for dentists scale, reimbursement rates shall be determined using the following methodology: (a) The fee for a covered service shall be the amount determined by multiplying the relative value unit specified in the relative values for dentists scale by the conversion factor specified in (1)(b) or (c). The department adopts and incorporates by reference the relative values for dentists scale published in 2004 for use in 2005 and 2006. Copies of the relative values for dentists scale are available upon request from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951. (b) The conversion factor used to determine the Medicaid payment amount for services provided to eligible individuals age 18 and above is $21.77. (c) The conversion factor used to determine the Medicaid payment amount for services provided to eligible individuals age 17 and under is $28.30.