The crash happened at 6:30 p.m. Tuesday on U.S. 87 near Lodge Grass.
The right front of the northbound pickup hit the left rear corner of the car, sending the car skidding into the right-side ditch.
The driver, a 23-year-old woman from Lodge Grass, was killed. Her name wasn't released. The passenger was taken to Indian Health Services at Crow Agency, the patrol said.
The driver of the car wasn't hurt.
The death - the 10th in Montana in three days - raises the state highway fatality toll to 62, two fewer than on April 18, 2005.
Authorities have also released the name of a 23-year-old Great Falls man who died Monday in a single-vehicle crash in Great Falls. Paul Burnett was killed when his Ford Bronco struck the concrete and brick entrance sign to the Meadow Lark Country Club.
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