REFERENCES: ARM 37.40.1460
Occupational therapy services under the Big Sky Bonanza (BSB) program are provided in an outpatient
setting for maintenance, palliative, or restorative purposes or as an extension of Medicaid State Plan
services. The scope and nature of these services do not otherwise differ from occupational therapy
furnished under the State Plan. This is a traditional waiver service.
Maintenance occupational therapy is provided when Medicaid State Plan occupational therapy is denied
and there is no expectation that the consumer's condition will improve significantly in a reasonable and
predictable time period. Maintenance occupational therapy is reimbursed only under the Home and
Community Based Services (HCBS) or BSB programs.
In addition to maintenance therapy provided under BSB, occupational therapy may also be restorative or
palliative and provided when therapy limits exceed what is allowable under Medicaid State Plan. Extended
State Plan occupational therapy services are those defined in ARM 37.86.601.
An Occupational Therapist must be:
1. Registered by the American Occupational Therapy Association; or
2. A graduate from an occupational therapy program approved by the Council on Medical Education of
the American Medical Association and engaged in the supplemental clinical experience required
before registration by the American Occupational Therapy Association.
Effect on Support Services and Spending Plan (SSSP)
Only those occupational therapy services included on the SSSP are allowable for BSB payment. The
provision of Medicaid State Plan occupational therapy services as defined in ARM 37.40.1460 should be
reflected in the supports section of the SSSP.
Restorative, palliative, or maintenance occupational therapy services under BSB may not be reimbursed
until Medicaid State Plan limits are met.
August 1, 2008 Senior & Long Term Care Page 1 of 1