Hospital Inpatient
New APR-DRG Payment Method (Updated October
1, 2008)
Provider Manuals (Updated April 25, 2006)
Medicaid Rules/Regulations (Updated May 9, 2006)
Fee Schedules (Updated September 30, 2008)
Notices and Replacement Pages (Updated September
30, 2008)
Other Resources (Updated January 2, 2008)
Remittance Advice Notice
Key Contacts (Updated March 1, 2007)
New
APR-DRG Payment Method
New APR-DRG Payment Method
10/2008
Provider
Manuals
General Information
For Providers
Medicaid billing manual with general information for all provider types.
04/2005
Hospital Inpatient
Services
This manual has billing instructions specific to your provider type.
07/2005
Critical Access
and Exempt Hospital Services
This manual has billing instructions specifically for critical access
and exempt hospitals.
01/2006
Passport
to Health Provider Handbook
Everything providers need to know to become a successful Passport provider.
09/2005
Medicaid
Rules/Regulations
Administrative
Rules of Montana (ARM)
Montana
Code Annotated (MCA)
Code
of Federal Regulations (CFR)
Fee
Schedules
Current Fee Schedule
in PDF Format
10/2008
Current Fee Schedule in Excel Format
10/2008
Current Fee
Schedule for Medicaid Mental Health for Clients 18 Years of Age and
Older in PDF Format
07/2008
Previous Fee Schedule
in PDF Format
10/2007
Previous Fee Schedule in Excel Format
10/2007
Current ATP Tests
and Fees in PDF Format
01/2007
Previous Fee Schedule
in PDF Format
11/2006
Previous Fee Schedule in Excel Format
11/2006
Previous Fee Schedule
in PDF Format
07/2006
Previous Fee Schedule in Excel Format
07/2006
Previous Fee Schedule
in PDF Format
01/2006
Previous Fee Schedule in Excel Format
01/2006
Previous ATP Tests
and Fees in PDF Format
04/2006
Previous Fee Schedule
in PDF Format
10/2005
Previous Fee Schedule
in Excel Format
10/2005
Previous Fee
Schedule in PDF Format
10/2004
Previous Fee
Schedule in Excel Format
10/2004
Previous
Fee Schedule in PDF Format
10/2003
Previous
Fee Schedule in Excel Format
10/2003
Previous ATP Tests
and Fees in PDF Format
03/2004
Previous
Fee Schedule for Medicaid Mental Health and MHSP Services for Clients
18 Years of Age and Older in PDF Format
07/2004
Previous
Fee Schedule for Medicaid Mental Health and MHSP Services for Clients
Under 18 years of Age in PDF Format
07/2004
Previous Fee
Schedule in PDF Format
10/2002
Previous Fee
Schedule in Excel Format
10/2002
Previous
Fee Schedule for Medicaid Mental Health and MHSP Services for clients
over 18 years of age in PDF Format
07/2003
Previous
Fee Schedule for Medicaid Mental Health and MHSP Services for clients
under 18 years of age in PDF Format
07/2003
Previous Fee
Schedule in PDF Format
10/2002
Previous Fee
Schedule in Excel Format
10/2002
Previous Fee
Schedule in PDF Format
08/2002
Previous Fee
Schedule in Excel Format
08/2002
Notices
and Replacement Pages
09/03/08
Tamper-Resistant
Rx Pad Update: Three Features Required October 1
09/03/08
Prior
Authorization
09/03/08
Present
on Admission Indicator -
Updated September 30!
09/03/08
Interim
Claims
08/12/08
Federal
Government May Request Medical Records -
Updated September 18!
06/23/08
Alcohol
and Chemical Inpatient Detoxification
05/29/08
When to Submit
an NDC (National Drug Code) If You Are Billing as a 340B Provider
05/22/08
Frequently
Asked Questions About NPI Reenrollment and Billing -
Updated June 17!
05/13/08
Medicaid/Medicare
Dual Eligible Take-Home and
Self-Administered Drugs
03/17/08
Resubmission
of Denied Claims - Updated March 19!
03/10/08
NPI Reenrollment
and Billing
02/20/08
Changes to Prior
Authorization for Circumcision - Updated
August 5!
02/13/08
Tamper-Resistant
Prescription Pads
02/04/08
Duplicate
Issue - Updated from January 31!
01/18/08
Possible
Duplicate Claims Processed Through Electronic Data Interchange
01/11/08
Vaccines for Children
(VFC)
12/17/07
Enhanced
Claims Editing—Assistant / Team / Co-Surgeon
12/17/07
Enhanced
Claims Editing—Multiple Evaluation and Management Services Provided
on the Same Day
12/11/07
Alcohol/Drug
Detox Medicaid Monies Recovery
12/03/07
NPI Requirement
for Institutional Healthcare Provider Claims
11/27/07
Cost Share
Changes
11/01/07
Enhanced
Claims Editing—Add-on Codes
11/01/07
Enhanced
Claims Editing—New Visit Evaluation and Management Codes
11/01/07
Enhanced
Claims Editing—Bloodhound ClaimsGuard®
10/03/07
VFC Update
10/01/07
Attending Provider
10/01/07
Tamper-Resistant
Prescription Pads — Postponed
09/20/07
Tamper-Resistant
Prescription Pads — Updated
08/01/07
Elimination
of ESOR
06/25/07
NPI on
the Web Portal
06/11/07
Ownership
and Control Information Required for Reenrollment
06/06/07
NPI Contingency
Plan Implemented, Reenrollment Extended
05/31/07
New CMS-1500
to Be Required Beginning July 2, 2007
04/16/07
VFC Update
- Updated from January 24!
04/16/07
Coverage of
HPV Vaccine
01/26/07
Mental Health
Claims May Have Been Underpaid
01/22/07
ATP Lab Fees
01/18/2007
Admit Hour to
Be Required for Institutional Claims
01/16/07
Inpatient
Out-of-State Hospital Changes
11/02/06
COBA Update
09/22/06
VFC Update
07/27/06
Billing for Clients
With Medicare and Medicaid—Revised
04/18/06
VFC Update
04/11/06
ATP Lab Fees
03/01/06
VFC Update
01/17/06
Critical Access
and Exempt Hospitals Manual Replacement Pages - New Instructions on
Completing Medicaid Hysterectomy Acknowledgement Form
12/28/05
Montana Medicaid
Provider Website Now Offers
Online Medical History
11/02/05
Critical Access
and Exempt Hospitals Manual Replacement Pages - Unbundling
10/11/05
Critical Access and
Exempt Hospitals Unbundling
07/28/05
Scales - Congestive
Heart Failure
07/01/05
Revised Processing
for Emergency Room Visits
07/01/05
VFC Update
06/01/05
Medicaid Coverage
Update
04/29/05
General Manual
Replacement Page - Member Number a Billable Number and Key Contacts
Updated
04/11/05
Dental Program Coverage
Changes
03/01/05
Hysterectomy Acknowledgement
Update
02/04/05
Introduction to
Preferred Drug List
12/01/04
Billing for Clients
with Medicare and Medicaid
11/05/04
General
Manual Replacement Pages - References to Medicaid Rules/Regulations
Added
10/01/04
Emergency Department
Claims Appeal Process
09/16/04
General Manual
Replacement Pages - Team Care and Nurse First Information Added
06/10/04
Team Care Program
- A New Component of the Passport to Health Program
06/01/04
Important Reminder
Regarding Sterilizations, Hysterectomies and Abortions
04/27/04
Observation
Bed Criteria - Updated
03/16/04
ATP Lab Fees
02/20/04
Mass Adjustment
01/22/04
Lab and Radiology
Services Covered Under MHSP Plan
01/01/04
VFC Changes
- Updated from December!
12/08/03
ED Claim Review
Procedure
12/01/03
Expanded Botox Criteria
12/01/03
VFC Changes
12/01/03
Discontinued Local
Codes
10/30/03
Continued Stay Review
for Inpatient Rehabilitation
10/17/03
Q & A Regarding
Reporting ICD-9-CM Procedure Codes
10/14/03
Form Locator Update
09/10/03
Notice dated 06/01/03 - Updated! Discontinued
Services and Services That Now Require Prior Authorization
08/29/03
Passport to Health
Implementation in Prairie County
08/29/03
DMEOPS Advisory Workgroup
Openings
08/20/03
Submitting
HIPAA Compliant Claims - Information for All Providers
08/05/03
ATP Lab Panel
Fees
08/05/03
Lab Panel Crosswalk
08/05/03
Observation
Bed Criteria
07/31/03
Passport and Emergency
Services
07/28/03
Hysterectomy Requirements
05/22/03
Air Transport Changes
05/12/03
Provider Rate and Payment Update
05/01/03
Outpatient Hospital
Lab Panel Update
04/30/03
Gastric Bypass Surgeries
and Circumcisions
04/01/03
Rehabilitation Update
02/03/03
New Billing Requirements
for UB-92 Billers
01/15/03
Dental Program Changes
01/10/03
New Provider
Notification Procedure and Medicaid Changes
10/01/02
Billing for Medicare
Crossovers after Medicare's 45 Day Response Time
09/01/02
Cost Sharing
07/01/02
2.6% Reduction
06/20/02
Passport to Health
24-Hour Availability
02/14/02
Weekly Payment
Available
10/17/01
Dental Implants
08/15/01
HCPCS Coding Clarification
05/29/01
Billing for Lab
Panels
05/09/01
Billing for Abortion
Services
Other
Resources
DRG
Calculation Worksheet
07/2007
DRG
Base Price and CCR History
10/2007
2008
Medicaid Payment Schedule
Medicaid claims payment schedule for 2008
01/2008
Self
Audit Policy and Procedure
06/2007
Current ATP Fees
2004-2007 ATP tests and fee schedule
01/2007
Carrier ID List
TPL insurance carriers listed by carrier ID
06/2007
Carrier ID
List
TPL insurance carriers listed by name
06/2007
EOB
R&R Crosswalk in PDF format
EOB R&R
Crosswalk in Excel format
With the implementation of HIPAA, Medicaid will discontinue the use
of Medicaid EOB codes and begin using HIPAA standard reason and remark
codes (R&R) . This document crosswalks the HIPAA standard R&R
codes to the Medicaid EOB codes.
01/26/04
Mental
Health Diagnosis Crosswalk
Covered diagnoses and crosswalk of ICD-9-CM codes to DSM-IV codes
01/2004
Remittance
Advice Notice
Your current RA message is as follows:
Mass Adjustment
June 6, 2007
Effective January 1, 2007, payment for services billed with revenue
code 510 was reduced to 80% of the applicable fee or APC for that line.
This change was implemented March 8, 2007. The mass adjustment for 510
revenue codes with dates of service 01/01/2007 through 03/08/2007 will
be run on June 6, 2007, and will show up on your June 11, 2007, remittance
advice.
Key
Contacts
Hospital
08/2002
CHIP
08/2002
Claims
08/2002
County Offices
01/2005
Eligibility
05/2006
Passport
07/2006
Policy Information
07/2006
Prior Authorization
03/2007
