Public Health Clinic
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 physician related services.
07/2008
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)
Current
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
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
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
Current Fee
Schedule for Medicaid Mental Health and MHSP Services for Clients 18
Years of Age and Older in PDF Format
07/2004
Current
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
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 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
01/2002
Previous Fee Schedule
in Excel Format
01/2002
Notices
and Replacement Pages
07/22/08
Billing
Procedures Regarding Electronic Claims (837P and 837I)
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
02/19/08
New HCPCS/CPT
Codes
01/18/08
Possible
Duplicate Claims Processed Through Electronic Data Interchange
01/11/08
Vaccines for Children
(VFC)
12/28/07
New Codes for
Smoking and Tobacco Use Cessation Counseling
12/26/07
WINASAP Upgrade
Required for NDC Data Collection
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
11/30/07
NDC Requirement
on All Physician-Administered Drugs -
Updated January 17!
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
09/28/07
Smoking and Tobacco
Use Cessation Counseling
08/01/07
Elimination
of ESOR
07/06/07
Coverage of
17 Alpha-Hydroxyprogesterone Caproate
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
03/08/07
New and Deleted Codes
12/22/06
Prior Authorization
for DMEPOS and Medical/Surgical Procedures Updated Phone and Fax Lines
11/08/06
Prior Authorization
on the Move
09/22/06
VFC Update
07/25/06
Physician Related
Services Manual Replacement Pages - Well Child EPSDT Update
04/18/06
VFC Update
03/01/06
VFC Update
02/10/06
New and Deleted Codes
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)
09/22/05
Telemedicine
07/28/05
Scales - Congestive
Heart Failure
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
03/01/05
Physician
Related Services Manual Replacement Pages - Hysterectomy Acknowledgement
Update
02/04/05
Introduction to
Preferred Drug List
02/01/05
New and Deleted Codes
and New Botox Criteria
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
02/01/04
New and Deleted
Codes
01/01/04
VFC
Changes - Updated From December!
12/23/03
Manual Replacement
Pages for Immunizations, PA Criteria, Family Planning, and Using Modifiers
12/01/03
High Risk Pregnant
Women (HRPW) Changes
12/01/03
Bilateral X-ray
Reimbursement Update
12/01/03
Expanded Botox
Criteria
12/01/03
VFC Changes
12/01/03
Discontinued Local
Codes
11/10/03
EMTALA Policy Change
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
06/01/03
Replacement
Pages for Physician Manual - New PA Requirements and Hysterectomy Information
05/12/03
Provider Rate and Payment Update
03/01/03
Pharmacy Prior Authorization
and Refill Changes
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
09/01/02
Cost Sharing Replacement
Page - Physician Related Services
07/01/02
2.6% Reduction
06/20/02
Passport to Health
24-Hour Availability
02/14/02
Weekly Payment
Available
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
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
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.
Key
Contacts
Public Health Clinic
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
