MONTANA MEDICAID
CLIENT INFORMATION
PROVIDER INFORMATION
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5010 HIPAA Information- Claim Instructions
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Schools
Provider Manuals (Updated April 27, 2012)
Medicaid Rules/Regulations (Updated May 9, 2006)
Fee Schedules (Updated September 19, 2011)
Medicaid Administrative Claiming (Updated
July 13, 2011)
CSCT Work Group (Updated July 19, 2005)
Notices and Replacement Pages (Updated April
27, 2012)
Other Resources (Updated May 2, 2012)
Remittance Advice Notice
Key Contacts (Updated April 13, 2012)
Provider
Manuals
General Information for Providers
Updated April 2012
Medicaid billing manual with general information for all provider types.
04/2012
School-Based Services
This manual has billing instructions specific to your provider type.
04/2012
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 for Medicaid Mental Health and MHSP Services for Clients
Under 18 Years of Age in PDF Format
09/2011
Current
Schools Fee Schedule in PDF Format
09/2011 FY 2012 Effective October 2011
Current
Schools Fee Schedule in Excel Format
09/2011 FY 2012 Effective October 2011
Current
Schools Fee Schedule in PDF Format
07/2011 FY 2012 Effective August 2011
Current
Schools Fee Schedule in Excel Format
07/2011 FY 2012 Effective August 2011
Current
Schools Fee Schedule in PDF Format Corrected
as of August 2, 2011
04/2011
Current
Schools Fee Schedule in Excel Format Corrected
as of August 2, 2011
04/2011
Previous
Schools Fee Schedule in PDF Format Corrected
as of August 2, 2011
01/2011
Previous
Schools Fee Schedule in Excel Format Corrected
as of August 2, 2011
01/2011
Previous
Fee Schedule in PDF Format Corrected
as of August 2, 2011
07/2010
Previous
Fee Schedule in Excel Format Corrected
as of August 2, 2011
07/2010
Previous
Fee Schedule in PDF Format Updated
February 10
10/2009
Previous Fee Schedule in Excel Format
Updated February 10
10/2009
Previous
Fee Schedule in PDF Format Updated
August 24
07/2009
Previous Fee Schedule in Excel Format
Updated August 24
07/2009
Previous
Fee Schedule in PDF Format Updated
August 24
04/2009
Previous Fee Schedule in Excel Format
Updated August 24
04/2009
Previous
Fee Schedule in PDF Format Updated
May 5
10/2008
Previous Fee Schedule in Excel Format
Updated May 5
10/2008
Previous
Fee Schedule in PDF Format
Updated July 29
07/2008
Previous
Fee Schedule in Excel Format Updated
July 29
07/2008
Previous
Fee Schedule in PDF Format
10/2007
Previous
Fee Schedule in Excel Format
10/2007
Previous
Fee Schedule in PDF Format
10/2006
Previous
Fee Schedule in Excel Format
10/2006
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
Fee Schedule in PDF Format
10/2005
Previous
Fee Schedule in Excel Format
10/2005
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
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
Medicaid
Administrative Claiming Program (MAC)
Coordination and Financial
Officer Training Summer 2011
06/2011
Financial
Data Report Q305
For July to September quarter, due by November 1, 2005
08/2005
Financial
Data Report Q405
For October to December quarter, due by February 1, 2006
08/2005
Participant
List Q405
For October to December quarter, due by September 1, 2005
08/2005
MAC Agreement Memorandum
of Understanding
This is the agreement that needs to be signed by the district representative
and the state Medicaid Administrator in order for your district to participate
in the Medicaid Administrative Claiming Program.
12/2005
Participant
Training Quiz
This quiz can be used at the end of your training session to help participants
code activities. It can be used individually or as a group discussion.
This paper can also serve as your documentation of training to keep
in your audit file.
09/2005
Answers
to Training Quiz
For the coordinator. Answers to Time Study Participant Quiz.
09/2005
MAC Coordinators'
Guide
This guide provides a program overview for the person responsible for
overseeing the implementation of the MAC program in the district or
cooperative. It details how to prepare the participant listing, training
time study participants, and managing the time study observation forms.
10/2004
MAC Financial
Data Guide
This guide details the requirements for the financial data report necessary
for submitting district expenditures in support of Medicaid services.
09/2004
MAC Time Study Guide
This guide provides time study participants information and guidelines
on how to complete the Random Moment Sample Time Study Observation forms.
It gives details and examples of the activity codes.
09/2004
MAC Activity Code
Reference Guide
This guide gives a detailed description of each activity code and provides
examples of when the code should be used. Coordinators will find this
useful when checking over the observation forms.
12/2004
Definition of
Activity Codes
This one-page definition of the activity codes should be copied onto
the back of every Random Moment Observation form. It gives examples
of when to use each activity code.
12/2004
MAC Time
Study Training Slide Show
This Power Point presentation is designed to train the staff who will
be participating in the RMS Time Study. If you don't have Microsoft
Power Point, you can download
Power Point viewer.
09/2005
CSCT
Work Group
April Meeting
Minutes
Minutes from the CSCT Work Group Committee Meeting on April 20, 2005
07/2005
March Meeting
Minutes
Minutes from the CSCT Work Group Committee Meeting on March 10, 2005
07/2005
February Meeting
Minutes
Minutes from the CSCT Work Group Committee Meeting on February 23, 2005
03/2005
January Meeting
Minutes
Minutes from the CSCT Work Group Committee Meeting on January 31, 2005
02/2005
December
Meeting Minutes
Minutes from the CSCT Work Group Committee Meeting on December 20, 2004
02/2005
November
Meeting Minutes
Minutes from the CSCT Work Group Committee Meeting on November 17, 2004
12/2004
October
Meeting Minutes
Minutes from the CSCT Work Group Committee Meeting on October 19, 2004
11/2004
Notices
and Replacement Pages
04/27/12
Replacement
Pages: School-Based Services, Covered Services
02/07/12
Comprehensive School
and Community Treatment (CSCT) Program Changes
11/07/11
Provider
Information on HIPAA 5010 837 Health Care Claim Transactions
09/09/11
HIPAA
5010/OCR Qualifier Changes Effective January 1, 2012
09/07/11
Payment Error Rate Measurement
(PERM)
08/25/11
CSCT
Team Number on 5010 Electronic Claim (837P) Transactions
Effective January 1, 2012
07/22/11
School-Based Service
Rate Changes
06/27/11
HIPAA
5010/OCR Qualifier Changes Effective January 1, 2012
06/09/11
School-Based
Services Manual Replacement Pages: Covered Services
04/12/11
Request:
Claims Submission, Date of Payment by June 30, 2011
11/17/10
Free
Care and CSCT
10/05/10
Changes
to NCCI Edits
07/28/10
Provider
Record Update Procedures Effective
Immediately
06/23/10
Cost
Sharing Exemption under ARRA
06/23/10
Resource
Based Relative Value Scale (RBRVS) Information
06/22/10
Electronic
Health Records Link
02/09/10
United
States 2010 Census
10/01/09
Healthy
Montana Kids Plan
03/16/09
Timely
Filing for Medicare Crossovers
10/20/08
Changes
in Transplant Coverage - Updated
October 27!
08/12/08
Federal
Government May Request Medical Records -
Updated September 18!
07/24/08
New FMAP Rate
Reflects Changes to Reimbursement on the Fee Schedule
07/24/08
Medicaid Administrative
Claiming (MAC) Program Extended
07/10/08
Multiple Conversion
Factors for RBRVS Providers
07/08/08
Adjustment for Claims
Using Multiple Conversion Factors
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!
03/17/08
Resubmission
of Denied Claims —
Updated March 19!
03/10/08
NPI
Reenrollment and Billing
03/03/08
Passport Requirement
Removed From School-Based Services
— Updated March 18, 2008
03/03/08
Place of Service
Change for CSCT Services
02/14/08
Elimination of
Medicaid Administrative Claiming (MAC)
01/29/08
Enhanced Claims
Editing—Medicare Correct Coding Initiative Edits (CCI)
01/18/08
Possible
Duplicate Claims Processed Through Electronic Data Interchange
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
NPI Requirement
for Fee-for-Service Healthcare Provider Claims
11/27/07
Cost
Share Changes
11/13/07
New Rates
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®
09/17/07
Montana Healthcare Schools Reenrollment
and Billing CSCT —
Updated May 5, 2008
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
05/01/07
Future FMAP Rate
Reflects Changes to Reimbursment on the Fee Schedule
02/23/07
New FMAP Rate
Reflects Changes to Reimbursement on the Fee Schedule
01/01/07
Federal Medical
Assistance Percentage (FMAP) Change
10/31/06
New Permission
to Bill Medicaid Form
07/28/06
Third-Party Insurance
Must Be Billed Prior to Billing Medicaid
04/25/06
School Manual Replacement
Pages - Revised Coordination of Benefits Information
10/06/05
School Manual Replacement
Pages - New Covered Services and Billing Information for CSCT and Therapy
08/31/05
Federal Medical
Assistance Percentage (FMAP) Change
07/28/05
Scales - Congestive
Heart Failure
05/12/05
School Manual Replacement
Pages - Updated Key Contacts and Place of Service
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
04/11/05
School-Based Services
Manual Replacement Pages - Updated Key Contacts
02/04/05
Introduction to
Preferred Drug List
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
08/31/04
CSCT Services
Audit and Program Requirements
08/30/04
School Replacement
Pages - Audiology Services Defined
07/29/04
New Fee Schedule
Reflects Reimbursement Changes
06/10/04
Team Care
Program - A New Component of the Passport to Health Program
04/26/04
Manual
Replacement Pages
02/25/04
Billing for CSCT
Services
01/14/04
Manual Replacement
Pages - Error Correction
12/23/03
Manual Replacement
Pages With CSCT Changes
10/12/03
CSCT Changes
10/01/03
Manual Replacement
Pages with Billing Corrections
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
05/05/03
CSCT Program Reinstated
04/14/03
New Services
01/10/03
New
Provider Notification Procedure and Medicaid Changes
01/10/03
Therapy Service
Limits
12/12/01
School-Based Services
Third Party Billing
Other
Resources
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
(R&R) codes. This document crosswalks the HIPAA standard R&R
codes to the Medicaid EOB codes.
02/2011
CSCT
Power Point Presentation
This Power Point slide show covers the CSCT program including history,
requirements, and how to document and bill Medicaid. If you don't have
Microsoft Power Point, you can download
Power Point viewer.
11/2007
CSCT
FAQs
11/2007
METNET
Q & A
Questions and answers from the September 28, 2005, METNET training.
10/2005
CSCT
Contract Boilerplate
Boilerplate language that may be used and modified to specify the requirements
appropriate for the school and CSCT provider.
09/2005
CSCT Audit
Checklist
A checklist to ensure school districts and cooperatives are in compliance
with CSCT requirements
08/2005
CSCT Conference
Call Summary
Intent of conference call was to clarify purpose of the worksheets schools
received from DPHHS to utilize for 1) certification of match and 2)
to assist the Department in establishing an annual rate for CSCT services
and to give an overview of how to complete the forms.
11/2004
CSCT Conference
Call Q & A
Questions and answers from the CSCT conference call regarding CSCT worksheets
11/2004
CSCT Summer
Program
Questions and answers regarding the CSCT summer program.
05/2004 (Updated 6/8)
Self
Audit Policy and Procedure
04/2009
Carrier
ID List
TPL insurance carriers listed by carrier ID
05/2012
Carrier
ID List
TPL insurance carriers listed by name
05/2012
CSCT Q & A
Questions and answers from the CSCT meeting held November 18, 2003
02/2004
Key
Contacts
School-Based Services
03/2009
Claims
03/2012
Public Assistance Offices
03/2012
Client Eligibility
04/2012
HMK/CHIP
12/2010
Passport
04/2012
Policy Information
03/2012
Prior Authorization
03/2012
