ARM 37.86.3515. CASE MANAGEMENT SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS, REIMBURSEMENT

(1) Case management services for adults with severe disabling mental illness will be reimbursed on a fee per unit of service basis. For purposes of this rule, a unit of service is a period of 15 minutes. (2) Group care coordination services may not exceed a maximum of eight participants per group. (3) The department may, in its discretion, designate a single provider to provide intensive case management services in a designated geographical region. Any provider designated as the sole intensive case management provider for a designated geographical region must, as a condition of such designation, agree to serve the entire designated geographical region. (4) The department will pay the lower of the following for case management services for adults with severe disabling mental illness: (a) the provider's actual submitted charge for services; or (b) the amount specified in the department's Medicaid Mental Health Fee Schedule adopted in ARM 37.86.2207.