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

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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 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 for Medicaid Mental Health and MHSP Services for Clients Under 18 Years of Age in PDF Format
08/2010

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

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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

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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

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Notices and Replacement Pages
04/27/12
Replacement Pages: School-Based Services, Covered Services

04/13/12
Replacement Pages; General Information for Providers, Medicaid Covered Services and Client Eligibility

02/07/12
Comprehensive School and Community Treatment (CSCT) Program Changes

01/06/12
Psychiatric Residential Treatment Faclity (PRTF) Prior Authorization Start Date Must Match Admission Date

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

07/18/11
Reimbursement Changes for Covered Ancillary Services Provided to Youth in a Psychiatric Residential Treatment Facility (PRTF) and Additional Ancillary Services Are Covered

07/18/11
Prior Authorization Requirements Discontinued for Targeted Case Management (TCM) and Outpatient Therapy Concurrent with Comprehensive School Community Treatment (CSCT)

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

05/07/09
FMAP Adjustment for School-Based Services Including
Comprehensive School and Community Treatment (CSCT) Program

03/16/09
Timely Filing for Medicare Crossovers

02/12/09
Reimbursement Change for Psychiatric Residential Treatment Facilities and How It Affects Other Montana Medicaid Providers

10/20/08
Changes in Transplant Coverage - Updated October 27!

09/16/08
School Manual Replacement Pages - Revised Key Contacts, Covered Services, Billing Procedures, and Claim Instructions

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

04/20/07
Montana Healthcare Schools Reenrollment With Managing Employee Social Security Number and Date of Birth

02/23/07
New FMAP Rate Reflects Changes to Reimbursement on the Fee Schedule

02/14/07
School Manual Replacement Pages - Revised Physician Order Information, New Private Duty Nursing Request Form

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

01/17/06
School Manual Replacement Pages - Revised Documentation Requirements, Restricted CSCT Services, Private-Duty Nursing Review Requirements, and School-Based Services Codes

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

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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

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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

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