Oral Surgeon
Provider Manuals (Updated July 25, 2006)
Medicaid Rules/Regulations (Updated May 9, 2006)
Fee Schedules (Updated September 24, 2008)
Notices and Replacement Pages (Updated October
27, 2008)
Other Resources (Updated December 31, 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
Dental and Denturist
Services
This manual has billing instructions specific to your provider type.
07/2005
Physician Related
Services
This manual has billing instructions specific to your provider type.
07/2006
Medicaid
Rules/Regulations
Administrative
Rules of Montana (ARM)
Montana
Code Annotated (MCA)
Code
of Federal Regulations (CFR)
Fee
Schedules
Current Fee Schedule
in PDF Format - Updated September
24!
07/2008
Current Fee Schedule in Excel Format -
Updated September 24!
07/2008
Previous Fee Schedule
in PDF Format
01/2008
Previous 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
01/2004
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
Notices
and Replacement Pages
10/20/08
Changes
in Transplant Coverage - Updated
October 27!
08/12/08
Federal
Government May Request Medical Records -
Updated September 18!
07/28/08
Fee Schedule and
Claim Forms
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
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
11/01/07
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
02/13/07
Current Dental
Terminology (CDT) and Updated Fee Schedule
07/25/06
Physician Related
Services Manual Replacement Pages - Well Child EPSDT Update
07/28/05
Scales - Congestive
Heart Failure
04/29/05
General Manual
Replacement Page - Member Number a Billable Number and Key Contacts
Updated
04/11/05
Dental Program Coverage
Changes
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
09/16/04
General Manual
Replacement Pages - Team Care and Nurse First Information Added
09/02/04
Dental Manual
Replacement Pages - Added "Per Quadrant" Requirements to Codes
D4240-D4261
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
12/23/03
Manual Replacement
Pages for Immunizations, PA Criteria, Family Planning, and Using Modifiers
10/16/03
Prior Authorization 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
08/05/03
ATP Lab Panel Fees
08/05/03
Lab Panel Crosswalk
08/05/03
Observation
Bed Criteria
07/31/03
Passport and Emergency
Services
07/28/03
Hysterectomy Requirements
and Physician Manual Replacement Pages
06/01/03
Replacement
Pages for Physician Manual - New PA Requirements and Hysterectomy Information
06/01/03
Discontinued Services
and Services That Now Require Prior Authorization
05/28/03
Change in Reimbursement
for Interactive Psychotherapy
05/12/03
Provider Rate and Payment Update
05/01/03
Outpatient Hospital
Lab Panel Update
04/30/03
Gastric Bypass Surgeries
and Circumcisions
03/01/03
Pharmacy Prior Authorization
and Refill Changes
03/01/03
New and Deleted HCPCS/CPT
Codes
03/01/03
Nutrition Services
Require Passport Approval
01/29/03
Prescription Drug
Update
01/27/03
Optometric Program
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
10/07/02
Presumptive Eligibility
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
07/01/02
Passport Provider
Approval Update
06/20/02
Passport to Health
24-Hour Availability
03/21/02
Prior Authorization
Reminders: DME, DMEOPS
02/14/02
Weekly Payment
Available
10/17/01
Dental Implants
01/26/01
New Definitions for
SED and SDMI
Other
Resources
2009 Medicaid
Payment Schedule
Medicaid claims payment schedule for 2009
12/2008
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
Physician Related
Services
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
