Podiatrist

Provider Manuals (Updated July 15, 2008)
Medicaid Rules/Regulations (Updated May 9, 2006)
Fee Schedules (Updated February 11, 2008)
Notices and Replacement Pages (Updated July 22, 2008)
Other Resources (Updated January 2, 2008)
Remittance Advice Notice
Key Contacts (Updated February 21, 2008)

Provider Manuals
General Information For Providers
Medicaid billing manual with general information for all provider types.
04/2005

Physician Related Services
This manual has billing instructions specific to your provider type.
07/2008

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Medicaid Rules/Regulations
Administrative Rules of Montana (ARM)
Montana Code Annotated (MCA)
Code of Federal Regulations (CFR)

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Fee Schedules
Current Fee Schedule in PDF Format
01/2008

Current Fee Schedule in Excel Format
01/2008

Previous Fee Schedule in PDF Format
10/2007

Previous Fee Schedule in Excel Format
10/2007

Previous Fee Schedule in PDF Format
01/2007

Previous Fee Schedule in Excel Format
01/2007

Current ATP Tests and Fees in PDF Format
01/2007

Previous Fee Schedule in PDF Format
07/2006

Previous Fee Schedule in Excel Format
07/2006

Previous ATP Tests and Fees in PDF Format
04/2006

Previous Fee Schedule in PDF Format
01/2006

Previous Fee Schedule in Excel Format
01/2006

Previous Fee Schedule in PDF Format
07/2005

Previous Fee Schedule in Excel Format
07/2005

Previous Fee Schedule in PDF Format
01/2005

Previous Fee Schedule in Excel Format
01/2005

Previous Fee Schedule in PDF Format
07/2004

Previous Fee Schedule in Excel Format
07/2004

Previous ATP Tests and Fees in PDF Format
03/2004

Previous Fee Schedule in PDF Format
01/2004

Previous Fee Schedule in Excel Format
01/2004

Previous Fee Schedule in PDF Format
07/2003

Previous Fee Schedule in Excel Format
07/2003

Previous Fee Schedule in PDF Format
01/2003

Previous Fee Schedule in Excel Format
01/2003

Previous Fee Schedule in PDF Format
07/2002

Previous Fee Schedule in Excel Format
07/2002

Previous Fee Schedule in PDF Format
01/2002

Previous Fee Schedule in Excel Format
01/2002

 

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Notices and Replacement Pages
07/22/08
Billing Procedures Regarding Electronic Claims (837P and 837I)

07/14/06
Physician-Related Services Manual Replacement Pages - Revised Key Contacts, Completing a Claim Form, Prior Authorization, Billing for Immunizations

07/10/08
Multiple Conversion Factors for RBRVS Providers

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!

04/09/08
Billing Procedures Regarding National Drug Code (NDC) for Providers Using the CMS-1500 and 837-P

03/17/08
Resubmission of Denied Claims - Updated March 19!

03/11/08
Billing Procedures Regarding National Drug Code (NDC) - Updated April 2!

03/10/08
NPI Reenrollment and Billing

02/04/08
Duplicate Issue

01/29/08
Enhanced Claims Editing—Medicare Correct Coding Initiative Edits (CCI)

01/18/08
Possible Duplicate Claims Processed Through Electronic Data Interchange

12/26/07
WINASAP Upgrade Required for NDC Data Collection

12/18/07
Radiopharmaceutical Pricing 2007 Update

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

12/03/07
NDC Requirement on All Physician-Administered Drugs - Updated January 17!

12/03/07
NPI Requirement for Fee-for-Service 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
Rendering Provider

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

01/22/07
ATP Lab Fees

12/22/06
Prior Authorization for DMEPOS and Medical/Surgical Procedures Updated Phone and Fax Lines

11/08/06
Prior Authorization on the Move

07/27/06
Billing for Clients With Medicare and Medicaid—Revised

07/25/06
Physician Related Services Manual Replacement Pages - Well Child EPSDT Update

04/25/06
Physician Related Services Manual Replacement Pages - Revised Instructions for Completing a Claim, Revised Information on How Cost-Sharing Affects Claim Payment

04/11/06
ATP Lab Fees

01/05/06
Increased Reimbursement for EPSDT Preventive Services

12/12/05
Physician Related Services Manual Replacement Pages - New EPSDT Chapter, Hysterectomy Acknowledgement Form, and Revised Information on Imaging Modifiers, Billing for Immunizations, and ER Visits for Clients Under Age 2

09/26/05
Blood Draws (CPT 36415 and 36416)

07/28/05
Scales - Congestive Heart Failure

04/29/05
General Manual Replacement Page - Member Number a Billable Number and Key Contacts Updated

04/04/05
Pricing Logic Changes for Professional (CMS-1500) Claims

03/01/05
Physician Related Services Manual Replacement Pages - Hysterectomy Acknowledgement Update

02/04/05
Introduction to Preferred Drug List

01/25/05
Physician Related Services Manual Replacement Pages - Rule References Added, Updates to Covered Services, PA and Modifiers

12/01/04
Billing for Clients With Medicare and Medicaid

11/16/04
Physician Manual Replacement Pages - Updated Prescription Drug PA Criteria

11/05/04
General Manual Replacement Pages - References to Medicaid Rules/Regulations Added

09/16/04
General Manual Replacement Pages - Team Care and Nurse First Information Added

09/15/04
Physician Manual Replacement Pages - Team Care Added

06/16/04
Physician Manual Replacement Pages - Clarification on Sterilizations, Hysterectomies, Abortions and HIPAA and Drug PA Update

06/10/04
Team Care Program - A New Component of the Passport to Health Program

03/16/04
ATP Lab Fees

12/23/03
Manual Replacement Pages for Immunizations, PA Criteria, Family Planning, and Using Modifiers

12/01/03
Bilateral X-ray Reimbursement Update

09/16/03
Physician Manual Replacement Pages for Hysterectomies and Prescription Drug PA Update

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

08/20/03
Physician Manual Replacement Pages - Includes New Emergency Services Policy and Hard Card Information

08/05/03
ATP Lab Panel Fees

08/05/03
Lab Panel Crosswalk

06/01/03
Discontinued Services That Now Require Prior Authorization

06/01/03
Replacement Pages for Physician Manual - New PA Requirements and Hysterectomy Information

05/12/03
Provider Rate and Payment Update

05/01/03
Outpatient Hospital Lab Panel Update

03/01/03
New and Deleted HCPCS/CPT Codes

01/29/03
Prescription Drug Update

01/10/03
New Provider Notification Procedure and Medicaid Changes

01/02/03
Drug Prior Authorization Changes

01/02/03
Prior Authorization Replacement Pages

12/01/02
Program Changes and Updates

10/01/02
Billing for Medicare Crossovers After Medicare's 45 Day Response Time

09/26/02
DME Update

09/01/02
Cost Sharing Replacement Page - Physician Related Services

09/01/02
Cost Sharing

07/01/02
2.6% Reduction

03/21/02
Prior Authorization Reminders: DME, DMEOPS

02/14/02
Weekly Payment Available

05/26/01
Billing for Lab Panels

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Other Resources
2008 Medicaid Payment Schedule
Medicaid claims payment schedule for 2008
01/2008

Self Audit Policy and Procedure
06/2007

Carrier ID List
TPL insurance carriers listed by carrier ID
06/2007
Carrier ID List
TPL insurance carriers listed by name
06/2007

Current ATP Fees
2004-2007 ATP tests and fee schedule
01/2007

Lab Panels 2007
List of codes that make up lab panels for 2004-2007
01/2007

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

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Remittance Advice Notice
Your current RA message is as follows:

New 1099 Process
December 14, 2006

Medicaid providers will see a change in the 1099s received for 2006 reporting Medicaid payments. Effective for calendar year 2006 and forward, ACS will no longer be generating and mailing a separate 1099 for Medicaid payments. The Department of Administration will be combining all payments by tax identification number into one 1099 instead of a separate 1099 for each Medicaid provider number. If you have any questions, please contact Roy Hinman at (406) 444-5932 or Susan Austad (406) 444-4060 at the Department of Public Health and Human Services.

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Key Contacts
Podiatrists
02/2008

CHIP
08/2002

Claims
08/2002

County Offices
01/2005

Eligibility
05/2006

Passport
07/2006

Policy Information
07/2006

Prior Authorization
03/2007

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