Psychiatrist
Provider Manuals (Updated July 25, 2005)
Medicaid Rules/Regulations (Updated May 9, 2006)
Fee Schedules (Updated
October 8, 2007)
Notices and Replacement Pages (Updated July
22, 2008)
Other Resources (Updated January 2, 2008)
Remittance Advice Notice
Key Contacts (Updated March 1, 2007)
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.
07/2006
Mental Health Services
This manual has billing instructions specific to your provider type.
10/2003
Prescription Drug
Prior Authorization
Prior authorization requirements and procedures are covered in this
manual.
11/2004
Completing the HCFA-1500
Form
Instructions for completing a CMS-1500 claim form (formerly HCFA-1500).
08/1998
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 18 Years of
Age and Older in PDF Format
10/2007
Current ATP Tests
and Fees in PDF Format
01/2007
Previous ATP Tests
and Fees in PDF Format
04/2006
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
Current Fee Schedule
in PDF Format
07/2003
Current 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 ATP Tests
and Fees in PDF Format
03/2004
Previous Fee Schedule
in PDF Format
07/2002
Previous Fee Schedule
in Excel Format
07/2002
Previous Fee Schedule
in PDF Format
07/2001
Previous Fee Schedule
in Excel Format
07/2001
Notices
and Replacement Pages
07/22/08
Billing
Procedures Regarding Electronic Claims (837P and 837I)
07/11/08
Changes in
Mental Health Services Plan for Adults Age 18 and Older
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
01/29/08
Enhanced
Claims Editing—Medicare Correct Coding Initiative Edits (CCI)
01/28/08
Expansion
of Provider Types for the Mental Health Services Plan
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
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®
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
01/26/07
Mental Health
Claims May Have Been Underpaid
01/22/07
ATP Lab Fees
07/25/06
Physician Related
Services Manual Replacement Pages - Well Child EPSDT Update
04/11/06
ATP Lab Fees
03/20/06
15-day Supply
Limit Clinical Edit on Initial Atypical Antipsychotic Prescriptions
01/05/06
Increased Reimbursement
for EPSDT Preventive Services
09/26/05
Blood Draws
(CPT 36415 and 36416)
09/22/05
Telemedicine
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
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
10/01/04
Emergency Department
Claims Appeal Process
09/16/04
General Manual
Replacement Pages - Team Care and Nurse First Information Added
06/16/04
Physician Manual
Replacement Pages - Clarification on Sterilizations, Hysterectomies,
Abortions and HIPAA and Drug PA Update
06/10/04
Prescription Drug
Prior Authorization Additions
06/10/04
Team Care Program
- A New Component of the Passport to Health Program
03/16/04
ATP Lab Fees
01/22/04
Lab and Radiology
Services Covered Under MHSP Plan
12/23/03
Chemical Dependency
Procedure Code Changes
12/23/03
Manual Replacement
Pages for Immunizations, PA Criteria, Family Planning, and Using Modifiers
12/01/03
High Risk Pregnant
Women (HRPW) Changes
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
07/25/03
MHSP Pharmacy
Changes
07/01/03
Mental Health Program Changes and Fees
06/01/03
Discontinued Services
That Now Require Prior Authorization
05/28/03
Change in Reimbursement
for Interactive Psychotherapy
05/01/03
Outpatient Hospital
Lab Panel Update
03/01/03
Pharmacy Prior Authorization
and Refill Changes
03/01/03
Nutrition Services
Require Passport Approval
01/29/03
Prescription Drug
Update
01/10/03
New Provider
Notification Procedure and Medicaid Changes
01/02/03
Drug Prior Authorization
Changes
10/01/02
Billing for Medicare
Crossovers after Medicare's 45 Day Response Time
09/01/02
Cost Sharing
06/20/02
Passport to Health
24-Hour Availability
02/14/02
Weekly Payment
Available
01/26/01
New Definitions for
SED and SDMI
06/01/01
Global Surgery Period
Billing
Other
Resources
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
Lab
Panels 2007
List of codes that make up lab panels for 2004-2007
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
Mental
Health Diagnosis Crosswalk
Covered diagnoses and crosswalk of ICD-9-CM codes to DSM-IV codes
01/2004
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
Mental Health
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
