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Medicaid State Plan Amendments

A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.

When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.

Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.

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Showing 1 to 10 of 63 results
Transmittal Number: MT-24-0018
State: Montana
Summary: This plan amendment removes specific per diem rates for Comprehensive Behavioral Health Treatment (CBHT) services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MT-24-0009
State: Montana
Summary: This plan amendment updates the bundled composite rate for services provided in an outpatient dialysis clinic.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MT-24-0005
State: Montana
Summary: This plan amendment incorporates provider rate increases and updates the date of the fee schedule for state plan services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MT-24-0006
State: Montana
Summary: This plan amendment updates the reimbursement methodology for nursing facility services for State Fiscal Year 2025.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MT-24-0007
State: Montana
Summary: This plan amendment provides for a four percent inflationary increase for inpatient hospital services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: MT-24-0004
State: Montana
Summary: This plan amendment updates the reimbursement fee schedule for psychiatric residential treatment facility (PRTF) services for State Fiscal Year 2025.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MT-24-0003
State: Montana
Summary: This SPA increases the professional dispensing fee to $17.01 for pharmacies with an annual prescription volume between 0 and 39,999 prescriptions; $14.73 for pharmacies with an annual prescription volume between 40,000 and 69,999; or $12.46 for pharmacies with an annual prescription volume greater than or equal to 70,000.
Approval Date:
Effective Date:
Topics:
  • Professional Dispensing Fee
  • Reimbursement
Links:
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Transmittal Number: MT-24-0008
State: Montana
Summary: This plan amendment updates the outpatient hospital services fee schedule, increases the conversion factor for outpatient hospital services, and amends the Medicaid statewide average outpatient hospital cost-to-charge ratio.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MT-23-0020
State: Montana
Summary: This amendment adopts version 40 of the APR-DRG grouper, which updates the relative weight values, and average national length of stay (ALOS).
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MT-23-0022
State: Montana
Summary: This state plan amends the fee schedules for services listed on the Introduction Pages.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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