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Montana Government Affairs

State Coordinator

Keith Keierleber
(406) 245-7129

Regional Coordinator

Ellen Bencken, RN,BSN,CNOR

(208) 908-1527 

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» RN Circulator Laws and Language


ADMINISTRATIVE RULES OF MONTANA TITLE 37: DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES CHAPTER 106: HEALTH CARE FACILITIES SUB-CHAPTER 4: MINIMUM STANDARDS FOR A HOSPITAL 37.106.401 MINIMUM STANDARDS FOR A HOSPITAL: GENERAL REQUIREMENTS (3) The department hereby adopts and incorporates by reference 42 CFR 482.2 through 482.62 and 42 CFR 482.66(b), revised as of October 1, 2002. 42 CFR 482.2 through 482.62 set forth the conditions of participation a hospital must meet to participate in the medicare program . . . . * * 42 CFR 482.51: Condition of participation: Surgical services. (1) The operating rooms must be supervised by an experienced registered nurse or a doctor of medicine or osteopathy. (3) Qualified registered nurses may perform circulating duties in the operating room. In accordance with applicable State laws and approved medical staff policies and procedures, LPNs and surgical technologists may assist in circulatory duties under the supervision of a qualified registered nurse who is immediately available to respond to emergencies.



» Registered Nurse First Assistants (RNFAs)

Reimbursement: Montana Code Annotated, Title 33, Chapter 22, Part 1 ยง33-22-114 (eff. July 1, 2011) Coverage required for services provided by physician assistants, advanced practice registered nurses, and registered nurse first assistants. An insurer, a health service corporation, or any employee health and welfare fund that provides accident or health insurance benefits to residents of this state shall provide, in group and individual insurance contracts, coverage as well as payment or reimbursement for health services provided by: (1) A physician assistant as normally covered by contracts for services supplied by a physician if health care services that the physician assistant is approved to perform are covered by the contract; (2) An advanced practice registered nurse, defined in 37-8-102, as normally covered by contracts for services supplied by a physician or a physician assistant if health care services that the advanced practice registered nurse is approved to perform are covered by the contract; and (3) A registered nurse first assistant, licensed under Title 37, chapter 8, as normally covered by contracts for surgical services supplied by a physician, a physician assistant, or an advanced practice registered nurse if surgical services that the registered nurse first assistant is approved to perform are covered by the contract.

Definition: None

Scope: Montana Board of Nursing, Declaratory Ruling, May 28, 1992 The role of an RN first assistant in preoperative preparation, intraoperative assistance and postoperative duties comes within the statute as administration of treatments authorized by physicians. The institution employing the RN as first assistant has a specific written policy regarding the circumstances in which registered professional nurses may perform as first assistants and specifying the qualifications and training necessary to perform as first assistants.

Guidelines for Perioperative Practice


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