Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.86 - MEDICAID PRIMARY CARE SERVICES › Subchapter 37.86.51 - Passport to Health Program › Rule 37.86.5110 - PASSPORT TO HEALTH PROGRAM: SERVICES

Current through Register Vol. 13, July 5, 2024
(1) A member must
				obtain services directly from, or through, a Passport referral by the member's
				primary care provider except for:
(a)
				obstetrical services, both inpatient and outpatient;
(b) family planning services as defined in
				Social Security Act 1905(a)(4)(c) and ARM
				37.86.1701;
(c) anesthesiology services;
(d) pathology services;
(e) ophthalmology services for medical
				conditions of the eye;
(f)
				immunization;
(g) testing and
				treatment for sexually transmitted diseases as defined in ARM
				37.114.101;
(h) testing for lead blood levels;
(i) dental, vision, hearing, and EPSDT
				screening and preventive services;
(j) school-based health services as defined
				in ARM 37.86.2230;
(k) swing-bed hospital services as defined in
				ARM 37.40.401;
(l) audiology services as defined in ARM
				37.86.702;
(m) hearing aid services as defined in ARM
				37.86.801;
(n) personal care services as defined in ARM
				37.40.1101;
(o) home dialysis services for end-stage
				renal disease as defined in ARM
				37.40.901;
(p) home infusion therapy services as defined
				in ARM 37.86.1501;
(q) mental health center services as provided
				in ARM 37.88.901 and
				37.88.905 through
				37.88.907;
(r) licensed psychologists services provided
				in ARM 37.88.601,
				37.88.605, and
				37.88.606;
(s) substance use disorder services as
				provided in ARM
				37.27.102;
(t) licensed clinical social work services
				provided in ARM
				37.88.201,
				37.88.205, and
				37.88.206;
(u) dental services as defined in ARM
				37.86.1001;
(v) licensed professional counselor services
				provided in ARM
				37.88.301,
				37.88.305, and
				37.88.306;
(w) outpatient drugs as defined in ARM
				37.86.1101;
(x) prosthetic devices, durable medical
				equipment, and medical supplies as defined in ARM
				37.86.1801;
(y) optometric services as defined in ARM
				37.86.2001;
(z) eyeglasses as defined in ARM
				37.86.2101;
(aa) transportation and per diem as defined
				in ARM 37.86.2401;
(ab) specialized nonemergency medical
				transportation as defined in ARM
				37.86.2501;
(ac) ambulance services as defined in ARM
				37.86.2601;
(ad) emergency services as defined in ARM
				37.82.102;
(ae) skilled care facility services as
				defined in ARM
				37.40.105;
(af) intermediate care facility services as
				defined in ARM
				37.40.106;
(ag) institution for mental disease services
				as provided in ARM
				37.88.1401,
				37.88.1402,
				37.88.1405,
				37.88.1406,
				37.88.1410,
				37.88.1411, and
				37.88.1420;
(ah) home and community-based services as
				defined in ARM
				37.40.1406;
(ai) freestanding dialysis clinic for
				end-stage renal disease services as defined in ARM
				37.86.4201;
(aj) case management services as defined in
				ARM 37.86.3301;
(ak) hospital inpatient laboratory and
				radiology (x-ray);
(al) admission
				for inpatient psychiatric services as provided in ARM
				37.86.2901,
				37.86.2902,
				37.87.1201, and
				37.87.1203;
(am) therapeutic youth group home or home
				support and therapeutic foster care services under the EPSDT program;
(an) hospice as defined in ARM
				37.40.801 and
				37.40.806; and
(ao) professional inpatient
				services.