ARM 37.86.3003. OUTPATIENT HOSPITAL SERVICES, EXCLUSIONS

(1) Outpatient hospital services do not include: (a) services excluded from coverage by the Medicaid program under ARM 37.85.207; (b) exercise programs and programs primarily educational in nature, including but not limited to: (i) cardiac rehabilitation exercise programs prior to January 1, 2006; (ii) nutritional programs; (iii) independent exercise programs, such as pool therapy, swim programs, or health club memberships; (iv) pulmonary therapy prior to January 1, 2006; (c) outpatient physical therapy, occupational therapy, and speech therapy services that are primarily maintenance therapy as defined in ARM 37.86.601; (d) experimental or investigational services such as the use of off-label drugs where this usage is not a national standard of practice, or non-FDA-approved use of drugs, biologicals, and devices; (e) services that do not comply with national standards of medical care; and (f) outpatient hospital services provided outside the borders of the United States will not be covered or reimbursed by the Montana Medicaid program.