Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Podiatrist

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Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Physician-Related Services 11/2016

This manual has information specific to your provider type.

Provider Manuals – Replacement Pages

General Information for Providers

In summary, the Telemedicine Chapter was added as a new chapter.  And the Medically Needy section of the Member Responsibilities Chapter page 6.5 was updated.



General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
General Information for Providers, January 2016: HELP Plan-Related Updates and Others
General Information for Providers, November 2015: Billing Procedures, Revenue Codes 25X and 27X
General Information for Providers, August 2015: Entire Manual
General Information for Providers, November 2014: Billing Procedures
General Information for Providers, September 2014: Billing Procedures
General Information for Providers, June 2014: Member Eligibility and Responsibilities, Presumptive Eligibility
General Information for Providers, June 2014: Entire Manual
If information is found on the website, it has been removed from the manual, and a link to the source is provided
General Information for Providers: Medicaid Covered Services and Client Eligibility

Physician-Related Services

 In summary, the Page 5.6 of the Billing Procedures chapter was amended to add information for locum tenens, several links were updated, and two blank pages were removed. The Table of Contents and Index sections were adjusted, several links were updated in the Introduction and Covered Services Chapter, the entire manual was formatted as approved by the September 2016 Manuals Meeting for initial 508 adaptations, and the Cover page was amended with the current date.
In summary, the entire manual has undergone formatting changes, the Billing Procedures section has had some minor language changes and the Cover reflects the current date.
In summary, The cost share section was removed from the Billing Procedures Chapter, related entries were removed from the Index Section adjustments were made to the Index Section , and the date was changed on the Cover Page
Physician-Related Services, August 2015: Entire Manual
Physician-Related Services, July 2014: Multiple Chapters
Physician-Related Services, March 2008: Key Contacts, Completing a Claim Form, Prior Authorization, Billing for Immunizations
Physician-Related Services, July 2006: Well-Child EPSDT Update
Physician-Related Services, April 2006: Revised Instructions for Completing a Claim, Revised Information on How Cost-Sharing Affects Claim Payment
Physician-Related Services, September 2005: New EPSDT, Hysterectomy Acknowledgement Form, Revised Information on Imaging Modifiers, Billing for Immunizations, and ER Visits for Clients under Age 2
Physician-Related Services, March 2005: Hysterectomy Acknowledgement Update
Physician-Related Services, January 2005: Rule References Added, Updates to Covered Services, PA and Modifiers
Physician-Related Services, November 2004: Updated Prescription Drug PA Criteria
Physician-Related Services, September 2004: Team Care Added
Physician-Related Services, July 2004: Clarification on Sterilizations, Hysterectomies, Abortions and HIPAA and Drug PA Update
Physician-Related Services, December 2003: Immunizations, PA Criteria, Family Planning, and Using Modifiers
Physician-Related Services, September 2003: Hysterectomies and Prescription Drug PA Update
Physician-Related Services, June 2003: New Emergency Services Policy and Hard Card Information
Physician-Related Services, August 2003: Hysterectomy Requirements
Physician-Related Services, June 2003: New PA Requirements and Hysterectomy Information
Physician-Related Services, January 2003: Prior Authorization
Physician-Related Services, September 2002: Cost Sharing


Medicaid Rules and Regulations

Fee Schedules – Podiatry

Podiatry Fee Schedules

PDF: January 2017 Podiatry
Excel:January 2017 Podiatry
PDF:July 2016 Podiatry Rev. 07/13/2016
Excel:July 2016 Podiatry Rev. 07/13/2016
PDF:January 2016 Podiatry
Excel:January 2016 Podiatry
PDF:July 2015 Podiatry
Excel:July 2015 Podiatry
PDF:January 2015 Podiatry
Excel:January 2015 Podiatry
PDF:July 2014 Podiatry
Excel:July 2014 Podiatry
PDF:January 2014 Podiatry
Excel:January 2014 Podiatry

Fee Schedules – ATP Tests and Fees

01/17/2017  PDF January 2017 ATP  EXCEL January 2017 ATP
12/24/2015 January 2016 ATP  
01/2015 January 2015 ATP  
01/2014 January 2014 ATP      

Provider Notices


05/26/2017 Federal Final Rule, "Nondiscrimination in Health Program and Activities” and Implication for Coverage of Services Related to Gender Transition
04/06/2017 New EPSDT Request Form
03/07/2017   Reminder: Billing for Services in ASCs


07/18/2016 Changes to Member Cost Share Update
05/19/2016 Changes to Member Cost Share
02/01/2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefi
01/15/2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01/19/2016


12/31/2015 Changes to Montana Medicaid
11/03/2015 Services Exempt from Passport to Health Referral
10/01/2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
08/03/2015 ICD-10 Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10)
07/31/2015 Adult and Pediatric Specialty Table of Services Available in Montana
06/09/2015 National Drug Code (NDC) Billing
02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU


12/18/2014 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Final Notice
09/16/2014 Adoption of the New Children's Mental Health Bureau's Medicaid Provider Manual into Administrative Rules of Montana
08/05/2014 Montana Prescription Drug Registry
06/12/2014 ICD-10 Delay
05/13/2014 PERM Provider Educational Webinars
04/22/2014 Modifier Changes for Professional Claim Billers
03/18/2014 Information Regarding CMS-1500
01/29/2014 Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Readiness Assessment Update
01/09/2014 Using Medicaid Card ID Number When Billing and Checking Eligibility
01/09/2014 Reimbursement Changes for Covered Ancillary Services Provided to Youth in a PRTF and Additional Information Pertaining to PRTF Services


12/23/2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Update
11/26/2013 ICD-10 Readiness
11/07/2013 Radiology Procedures and Medicaid Passport to Health Referrals
11/07/2013 Podiatrists and Medicaid Passport to Health Referrals
10/08/2013 Referrals for Audiology Services
10/03/2013 Mid-Level Provider Services in a NICU Setting
09/27/2013 Changes to Prior Authorization Requirements for Therapeutic Youth Group Homes – Additional Information
09/24/2013 Changes to Contract with Magellan Medicaid Administration (MMA)
09/11/2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes
09/03/2013 Changes to Contract with Magellan Medicaid Administration (MMA)
09/03/2013 Passport to Health Member Pending Lists and Provide Caseload Capacities
07/10/2013 Psychiatrist Service Reimbursement Change and Timely Billing Requirement
07/08/2013 Montana Medicaid DSM-5 Implementation
07/05/2013 Medicaid/HMK Plus and Sports Physicals
06/20/2013 Montana Plan First – Additional Information
05/28/2013 DPHHS to Discontinue Temporary Hotline Number
05/13/2013 Montana Plan First – Revised List of Plan First Covered Services
05/06/2013 Passport to Health Disenrollment Requirements for Providers Disenrolling a Member
02/25/2013 Vaccine Administration Changes
02/21/2013 Primary Care Enhanced Payment Program Notification
02/19/2013 Montana Medicaid HIPAA Operating Rules Upgrade
02/12/2013 BRCA1 and BRCA2 Testing Update
02/11/2013 Passport and Medical Evaluation with Psychotherapy Services
02/11/2013 Montana Plan First Additional Information Updated

Other Resources

EOB R&R Crosswalk in PDF Format and EOB R&R Crosswalk in Excel Format 02/2011
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.

Lab Panels 2007 01/2007
List of codes that make up lab panels for 2004–2007.

Prior Authorization Criteria for Specific Services

Rebateable Manufacturers 04/2017

SURS Provider Self-Audit Protocol 10/2015


To locate older documents, access the Archive Page.