BHDD Medicaid and Non-Medicaid Services Provider Manual - Effective July 01, 2023

Printing the manual material found at this website for long-term use is not advisable. Department Policy material is updated periodically and it is the responsibility of the users to check and make sure that the policy they are researching or applying has the correct effective date for their circumstances.  State Website Disclaimer.

Non Medicaid 

Table of Contents

Section/    Subsection

Title/Content

Issued/  Revised
   

Introduction

  
  001NM Purpose 07/1/2023
  003NM Definitions 10/01/2022

100

Section 1 - Utilization Management

  
  110NM Utilization Management Overview 10/01/2022

200

Section 2 - Consultation
  215NM Case Consultation 07/1/2023

300

Section 3 - Non-Medicaid Individual Specialized Services

  
  305NM Goal 189 07/1/2023

Medicaid 

Table of Contents
Section/
Subsection
Title/Content Issued/
Revised
   

Introduction

  
  001 Purpose 10/01/2022
  002 Definitions 10/01/2022

100

Section 1 - General Requirements

  
  105 Severe and Disabling Mental Illness 5/12/2023
  110 Substance Use Disorder 10/01/2022
  115 Assessments 10/01/2022
  120 Individualized Treatment Plans for Behavioral Health Treatment 10/01/2022
  130 Progress Notes 10/01/2022
  135 Continuing Care Plan 10/01/2022

200

Section 2 - Utilization Management
  205 Requesting a Prior Authorization – Non-Acute Services 10/01/2022
  206 Requesting Auto Authorization – Acute Services 10/01/2022
  206QA Auto-Authorization Quality Assurance 10/01/2022
  210 Requesting a Continued Stay Review – Non-Acute Services 10/01/2022
  215 Utilization Review Determinations and Notifications 5/12/2023
  220 Reconsideration Review Process 10/01/2022
  230 Integrated Service Delivery 7/1/2023

300

Section 3 - Administrative Reviews

  
  305 Retrospective and Quality Reviews 10/01/2022
  310 Administrative Review, Fair Hearing, & Sanctions 5/12/2023

400

Section 4 - Medicaid Adult Mental Health Services

  
  405 MH Targeted Case Management (TCM) 10/01/2022
  410 Illness Management and Recovery Services (IMR) 10/01/2022
  415 Certified Behavioral Health Peer Support Services (CBHPSS) – Mental Health 5/12/2023
  420 Community Based Psychiatric Rehabilitation Support Services (CBPRS) 5/12/2023
  425 Mental Health (MH) Outpatient (OP) Therapy 10/01/2022
  430 Dialectical Behavior Therapy (DBT) 10/01/2022
  435 Day Treatment (Day TX) 10/01/2022
  440 Adult Foster Care (AFC) 10/01/2022
  445 Behavioral Health Group Home (BHGH) 5/12/2023
  450 Crisis Receiving and Stabilization Program 10/01/2022
  452 Mobile Crisis Response Services 07/1/2023
  454 Mobile Crisis Care Coordination 07/1/2023
  455 Montana Assertive Community Treatment (MACT) 5/12/2023
455QM Montana Assertive Community Treatment Quality Measures (MACT QM) (New) 10/01/2022
  460 Program of Assertive Community Treatment (PACT) 5/12/2023
  465 Acute Partial Hospital Program (PHP) 10/01/2022
  470 Acute Inpatient Hospital 10/01/2022
  475 Transcranial Magnetic Stimulation (TMS) 10/01/2022
  475QM Transcranial Magnetic Stimulation (TMS) QM 10/01/2022

500

Section 5 – Medicaid Substance Use Disorder (SUD) Services

  
  505 Specimen Collection for SUD Drug Testing 10/01/2022
  510 SUD Targeted Case Management 10/01/2022
514 Screening, Brief Intervention, and Referral to Treatment (SBIRT) 10/01/2022
  515 SUD Certified Behavioral Health Peer Support Services (CBHPSS) - Adult 5/12/2023
  520 SUD Outpatient (OP) Therapy (ASAM 1.0) 10/01/2022
  525 SUD Intensive Outpatient (IOP) Therapy (ASAM 2.1) 5/12/2023
  530 SUD Partial Hospitalization (ASAM 2.5) 10/01/2022
  535 SUD Clinically Managed Low-Intensity Residential (ASAM 3.1) 10/01/2022
536 SUD Withdrawal Management (ASAM 3.2) (New) 10/01/2022
537 SUD Clinically Managed Population‐specific High‐Intensity Residential (ASAM 3.3) Adult (New) 10/01/2022
  540 SUD Clinically Managed High-Intensity Residential (ASAM 3.5) 10/01/2022
  545 SUD Medically Monitored Intensive Inpatient (ASAM 3.7) 10/01/2022
  550 Medication Assisted Treatment (MAT) 10/01/2022