TRAUMATIC BRAIN INJURY (TBI) SERVICES PROVIDER IN MONTANA

Fatumata Kaba
Aug 6
4 min read

SUPPORTING RECOVERY AND INDEPENDENCE FOR INDIVIDUALS WITH BRAIN INJURIES THROUGH SPECIALIZED CARE

Traumatic Brain Injury (TBI) Services in Montana provide comprehensive support for individuals who have sustained brain injuries, focusing on rehabilitation, community integration, and enhancing daily functioning. These services aim to improve quality of life, promote independence, and support community engagement. TBI Services are authorized under the 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 TBI Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Brain Injury Alliance of Montana (BIAMT)

Role: Supports providers with resources, advocacy, and training related to brain injury care and community integration.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid-funded TBI Services meet HCBS quality, person-centered planning, and participant protection standards.

2. TBI SERVICES OVERVIEW

Traumatic Brain Injury Services assist individuals who have experienced brain trauma, helping them regain functional abilities and reintegrate into the community.

Approved providers may deliver:

Rehabilitation Therapy: Physical, occupational, and speech therapy to restore functional abilities.
Cognitive Rehabilitation: Addressing memory, problem-solving, and executive function challenges.
Behavioral Support: Managing changes in mood, behavior, and coping strategies.
Community Reintegration: Assisting with social skills, community access, and vocational training.
Personal Assistance: Support with daily activities, personal care, and health monitoring.
Family Education: Training family members to understand and support the individual’s needs.

All services are delivered in accordance with the Individualized Service Plan (ISP), emphasizing safety, autonomy, and rehabilitation.

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 TBI Services provider via the Montana Medicaid Provider Enrollment Portal.
Obtain necessary professional licenses (e.g., Physical Therapist, Occupational Therapist, Behavioral Specialist).
Maintain general liability and professional liability insurance.
Develop comprehensive policies for safety, rehabilitation planning, and documentation.
Ensure staff meet background checks, health screenings, and specialized TBI care training.

4. MONTANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application through the Montana Medicaid Provider Enrollment Portal for TBI 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 therapeutic approaches, safety protocols, and staff qualifications.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for TBI 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, Behavioral Specialist)
Proof of general and professional liability insurance
TBI Services Policy & Procedure Manual, including:
- Rehabilitation and therapy protocols
- Cognitive support and behavioral intervention guidelines
- Safety procedures and risk management
- Documentation standards for progress tracking and Medicaid billing
- Staff credentialing, background checks, and ongoing training records
- HIPAA compliance, participant rights, and grievance handling
- Emergency preparedness and crisis management policies

6. STAFFING REQUIREMENTS

Role: TBI Program Director

Requirements: Master’s degree in rehabilitation sciences, healthcare, or a related field; supervisory experience; specialized training in brain injury care.

Role: Rehabilitation Therapists (PT, OT, SLP)

Requirements: State licensure, professional certifications, CPR/First Aid certification, training in TBI care, and background clearance.

Role: Behavioral Support Specialists

Requirements: Certification in behavioral health or psychology; experience with brain injury rehabilitation; background clearance.

All staff must complete: