53-6-124. Definitions, MCA

Montana Code Annotated 2025

TITLE 53. SOCIAL SERVICES AND INSTITUTIONS

CHAPTER 6. HEALTH CARE SERVICES

Part 1. Medical Assistance -- Medicaid

Definitions

53-6-124. Definitions. As used in 53-6-101, 53-6-116, 53-6-125, 53-6-127, and this section, the following definitions apply:

(1) "Conversion factor" means the dollar value that is multiplied by the appropriate relative value unit to calculate a price for a service provided by a physician.

(2) "Department" means the department of public health and human services.

(3) "Direct patient care agreement" means an agreement for health care services as provided for in 50-4-107.

(4) "Medicaid" means the Montana medical assistance program established under Title 53, chapter 6.

(5) "Physician" has the meaning provided in 37-3-102.

(6) "Policy adjuster" means a factor by which the fee determined under 53-6-125 is multiplied to increase the fee paid by medicaid for certain categories of services.

(7) "Relative value unit" means a numerical value assigned in the resource-based relative value scale to each procedure code used to bill for services provided by a physician.

(8) "Resource-based relative value scale" means the medicare resource-based relative value scale contained in the physician's medicare fee schedule adopted by the centers for medicare and medicaid services of the U.S. department of health and human services.

History: En. Sec. 1, Ch. 414, L. 2007; amd. Sec. 1, Ch. 397, L. 2011; amd. Sec. 3, Ch. 663, L. 2025.