53-6-124. Definitions. - Montana Statutes

     53-6-124. Definitions. As used in 53-6-124 through 53-6-127, the following definitions apply:
     (1) "Conversion factor" means the average of the conversion factors used by the top five insurers or third-party administrators providing disability insurance to the most beneficiaries within the state in January 2007 who use the resource-based relative value scale to determine fees for covered services. This January 2007 conversion factor is applicable for state fiscal years 2008, 2009, 2010, 2011, 2012, and 2013. In state fiscal year 2014 and for each state fiscal year thereafter, the conversion factor is the average of the conversion factors used by the top five insurers or third-party administrators providing disability insurance to the most beneficiaries within the state who use the resource-based relative value scale to determine fees for covered services.
     (2) "Department" means the department of public health and human services.
     (3) "Medicaid" means the Montana medical assistance program established under Title 53, chapter 6.
     (4) "Physician" has the meaning provided in 37-3-102.
     (5) "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.
     (6) "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.
     (7) "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.