Rehabilitation Services in Montana assist individuals with disabilities, injuries, or chronic conditions to improve their physical, cognitive, and social functioning. These services promote recovery, enhance independence, and support community integration. Rehabilitation Services are authorized under Montana Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Montana Department of Public Health and Human Services (DPHHS)
Role: Administers Medicaid waiver funding for Rehabilitation Services and manages provider enrollment, service authorization, and reimbursement

Agency: Developmental Disabilities Program (DDP) within DPHHS
Role: Oversees quality standards, service delivery, and compliance for Rehabilitation Services within HCBS waiver programs

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Medicaid-funded Rehabilitation Services meet HCBS quality, person-centered planning, and participant protection standards

2. REHABILITATION SERVICES OVERVIEW

Rehabilitation Services support individuals recovering from injuries, living with disabilities, or managing chronic conditions by providing therapeutic interventions and skill development.

Approved providers may deliver:

• Physical Rehabilitation: Therapy to improve mobility, strength, and physical function
• Occupational Therapy: Assistance with daily living skills and functional tasks
• Speech-Language Therapy: Improving communication, swallowing, and cognitive skills
• Behavioral Rehabilitation: Addressing behavioral challenges and promoting adaptive skills
• Social and Community Integration: Facilitating community participation and social engagement
• Cognitive Rehabilitation: Enhancing memory, problem-solving, and independent living skills

All rehabilitation services are customized to the participant’s Individualized Service Plan (ISP) and adhere to Medicaid waiver guidelines

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the Montana Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid Waiver Rehabilitation provider via the Montana Medicaid Provider Enrollment Portal
• Maintain general liability and professional liability insurance
• Obtain applicable professional licenses (e.g., Physical Therapist, Occupational Therapist) as required by Montana state law
• Develop policies for rehabilitation planning, progress tracking, and service documentation
• Ensure staff meet health screenings, background checks, and relevant training requirements

4. MONTANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the Montana Medicaid Provider Enrollment Portal for Rehabilitation Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, professional licenses, insurance certificates, and staff qualifications.

Program Readiness Review:

• DPHHS evaluates provider readiness, including staff credentials, therapeutic protocols, and safety procedures.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Rehabilitation Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Montana Secretary of State)
• IRS EIN confirmation
• NPI confirmation
• Professional licenses (e.g., PT, OT, Speech Therapy certifications)
• Proof of general and professional liability insurance

Rehabilitation Services Policy & Procedure Manual including:

• Assessment and therapy planning protocols
• Safety and risk management procedures
• Documentation standards and progress tracking
• Staff credentialing, training, and continuing education records
• HIPAA compliance and participant rights policies
• Medicaid billing practices and audit readiness

6. STAFFING REQUIREMENTS

Role: Rehabilitation Program Director
Requirements: Licensed therapist (PT, OT, or Speech Therapist), experience in program management preferred.

Role: Rehabilitation Therapists (PT, OT, SLP)
Requirements: State licensure, CPR/First Aid certification, specialized training in rehabilitation techniques, background clearance.

All staff must complete:

• Therapeutic interventions and safety training
• HIPAA compliance and documentation training
• Ongoing professional development and competency assessments
• Annual safety and infection control training

7. MEDICAID WAIVER PROGRAMS

Rehabilitation Services are available under the following Montana Medicaid Waivers:

• Comprehensive Waiver for Individuals with Developmental Disabilities
• Big Sky Waiver (Aged and Disabled)
• Traumatic Brain Injury (TBI) Waiver
• Children's Autism Waiver
• Community Supports Waiver for Adults with Physical Disabilities

Services may include:

• Physical and occupational therapy to enhance mobility and function
• Speech and language therapy to improve communication and cognition
• Behavioral rehabilitation to develop adaptive skills
• Social integration and community involvement activities
• Ongoing evaluation and progress tracking

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months

Phase: Montana Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days

Phase: Medicaid Billing Setup and Rehabilitation Service Launch
Timeline: 30–45 days

9. CONTACT INFORMATION

Montana Department of Public Health and Human Services (DPHHS)
Website: https://dphhs.mt.gov/

Developmental Disabilities Program (DDP) — DPHHS
Website: https://dphhs.mt.gov/dsd/developmentaldisabilities

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/

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10. SCOPE OF WORK

• Business registration, Medicaid enrollment, and licensing assistance
• Policy manual development for therapy and rehabilitation services
• Staff credentialing support and training program templates
• Medicaid billing system setup and audit-prepared claims management
• Branding, website development, and outreach strategies
• Quality assurance systems for compliance and documentation
• Networking with healthcare providers for referral opportunities