Provider Based Clinics
There has been clarification regarding the Provider Based Clinic definition. Effective 7/1/13 Provider Based Clinics are no longer defined as a “facility” under ARM 24.29.1401A(14) http://www.mtrules.org/gateway/RuleNo.asp?RN=24%2E29%2E1401A. For services provided in a Provider Based Clinic, only a professional fee may be billed and facilities may no longer bill a facility fee for the same service.
If you have any questions regarding this new rule change, please contact the Montana State Fund Medical team at 495-5011.