Mont. Admin. r. 37.86.202 - MID-LEVEL PRACTITIONER SERVICES, DEFINITIONS
For the purpose of these rules, the following definitions will apply:
(1) "Advanced practice
registered nurse" means a registered professional nurse licensed as provided in
Title 37, chapter 8, MCA and ARM Title 24, chapter 159, subchapter 14 and
includes nurse practitioner, nurse anesthetist, and nurse midwife and clinical
nurse specialist.
(2) "Clinical
nurse specialist" means a person who is licensed in accord with
37-8-405 through
37-8-407, MCA and ARM
24.159.1412,
24.159.1413,
24.159.1414, and
24.159.1485.
(3) "Delivery services" means services
necessary to protect the health and safety of the woman and fetus from the
onset of labor through delivery.
(4) "Early elective delivery" means either a
nonmedically necessary labor induction or cesarean section that is performed
prior to 39 weeks and 0/7 days gestation.
(5) "Independent employment status" means
that a separate federal tax identification number is obtained for the mid-level
practitioner and the billed services are not provided in the course of the
mid-level practitioner's employment by or contract with a physician, hospital,
or ambulatory surgical center.
(6)
"Mid-level practitioner" means the following professionals:
(a) advanced practice registered nurse;
and
(b) physician
assistant.
(7)
"Mid-level practitioner services" means those services provided by mid-level
practitioners in accord with the laws and rules defining and governing through
licensing and certification the practices of advanced practice registered
nurses and physician assistants.
(8) "Nurse anesthetist" means a person who is
licensed in accord with
37-8-405 through
37-8-407, MCA and ARM 24.159.1412,
24.159.1413, 24.159.1414, and 24.159.1480.
(9) "Nurse midwife" means a person who is
licensed in accord with
37-8-405 through
37-8-407,
37-8-409, MCA and ARM 24.159.1412,
24.159.1413, 24.159.1414, and 24.159.1475.
(10) "Nurse practitioner" means a person who
is licensed in accord with
37-8-405 through
37-8-407, MCA and ARM 24.159.1412,
24.159.1413, 24.159.1414, and 24.159.1470.
(11) "Physician assistant" means a person who
is licensed as provided in Title 37, chapter 20, MCA and ARM Title 24, chapter
159, subchapter 14.
(12)
"Postpartum services" means services rendered to a woman during the 12-month
postpartum period after pregnancy ends for any health conditions or
complications that are pregnancy-related.
(13) "Pregnancy-related services" means
services for the treatment of conditions or complications that exist or are
exacerbated because of pregnancy.
(14) "Prenatal services" means services
directed at protecting and insuring the health of the woman and the fetus
during pregnancy.
(15) The
definitions found in the introduction to Physicians Current Procedural
Terminology, fourth edition (CPT4), published by the American Medical
Association of Chicago, Illinois and adopted at ARM
37.86.101 set forth meanings of
terms commonly used by the Montana Medicaid program in implementation of the
program's mid-level practitioner fee schedule.
(16) The "Physician-Related Services Manual"
means the physician-related services manual adopted at ARM 37.86.101. It
governs the administration of the mid-level practitioner program.
Notes
AUTH: 53-2-201, 53-6-113, MCA; IMP: 53-6-101, MCA
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.