Administrative Rules of Montana
Department 23 - JUSTICE
Chapter 23.15 - OFFICE OF VICTIMS SERVICES
Subchapter 23.15.4 - Forensic Rape Examination Payment Program
Rule 23.15.404 - PROVIDER BILLING AND REIMBURSEMENT
Universal Citation: MT Admin Rules 23.15.404
Current through Register Vol. 18, September 20, 2024
(1) To be eligible for reimbursement for the covered costs of the forensic rape examination, the medical provider must, within 90 days of performing the examination:
(a) submit the FREPP claim
form;
(b) provide a copy of the
patient information form;
(c)
provide an itemized statement of charges listing current procedural terminology
(CPT) codes on a standard health care financing administration (HCFA) form;
and
(d) provide copies of all
pertinent treatment records.
(2) All billing paperwork should be mailed to the Office of Victim Services, ATTN: FREPP, P.O. Box 201410, 1712 9th Ave., Helena, MT 59620-1410.
46-15-411, MCA; IMP, 46-15-411, MCA;
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