Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Ambulatory Surgical Center

Main Content

Ambulatory Surgical Center

Ambulatory Surgical Center

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Ambulatory Surgical Center Services 08.2016

This manual has information specific to your provider type.

Provider Manuals – Replacement Pages

General Information for Providers

02/07/2017 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.

08.02.2016

07.12.2016

 

General Information For Providers, July 2016

01.19.2016 General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
01.15.2016 General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
12.31.2015 General Information for Providers, January 2016: HELP Plan-Related Updates and Others
11.17.2015 General Information for Providers, November 2015: Billing Procedures, Revenue Codes 25X and 27X
07.31.2015 General Information for Providers, August 2015: Entire Manual
11.19.2014 General Information for Providers, November 2014: Billing Procedures
10.08.2014 General Information for Providers, September 2014: Billing Procedures
07.22.2014 General Information for Providers, June 2014: Member Eligibility and Responsibilities, Presumptive Eligibility
06.30.2014 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.
04.13.2012 General Information for Providers, April 2012: Medicaid Covered Services and Client Eligibility
04.29.2005 General Information for Providers, April 2005: Member Number a Billable Number and Key Contacts Updated
11.05.2004 General Information for Providers, November 2004: References to Medicaid Rules and Regulations Added
09.16.2004 General Information for Providers, September 2004: Team Care and Nurse First Information Added

Ambulatory Surgical Center

08.08.2016

Ambulatory Surgical Center, August 2016: In Summary, the Cost Share section of the Billing Procedure Chapter was removed and replaced with a referral to the Cost Share section of the General Manual. The Cover Page was changed to reflect the current manual edition date.

 

12.31.2015 Ambulatory Surgical Center, January 2016: HELP Plan-Related Updates and Others
09.23.2015 Ambulatory Surgical Center, August 2015: Entire Manual
08.22.2011 Ambulatory Surgical Center, June 2011: Key Contacts and Websites, Passport, and Other

Passport to Health

11.09.2015 Passport to Health, November 2015: Passport Referrals

Medicaid Rules and Regulations

Fee Schedules – Ambulatory Surgical Center (ASC)

PDF Excel
01/17/2017 January 2017 ASC 01/17/2017 January 2017 ASC
10/04/2016 October 2016 ASC 10/04/2016 October 2016
07.01.2016 July 2016 ASC Rev. 08.05.2016 07.01.2016 July 2016 ASC Rev. 08.05.2016
04.05.2016 April 2016 ASC 04.05.2016 April 2016 ASC
01.05.2016 January 2016 ASC 01.05.2016 January 2016 ASC
10.20.2015 October 2015 ASC 10.20.2015 October 2015 ASC
07.2015 July 2015 ASC 07.2015 July 2015 ASC
05.04.2015 April 2015 ASC 05.04.2015 April 2015 ASC
01.20.2015 January 2015 ASC 01.20.2015 January 2015 ASC
10.07.2014 October 2014 ASC 10.07.2014 October 2014 ASC
09.24.2014 July 2014 ASC Rev. 09.2014 09.24.2014 July 2014 ASC Rev. 09.2014
05.13.2014 April 2014 ASC 05.13.2014 April 2014 ASC
01.2014 January 2014 ASC 01.2014 January 2014 ASC
10.2013 October 2013 ASC 10.2013 October 2013 ASC
07.2013 July 2013 ASC 07.2013 July 2013 ASC
04.2013 April 2013 ASC 04.2013 April 2013 ASC
01.2013 January 2013 ASC 01.2013 January 2013 ASC
11.06.2012 October 2012 ASC 11.06.2012 October 2012 ASC
08.06.2012 July 2012 ASC 08.06.2012 July 2012 ASC
05.21.2012 April 2012 ASC 05.21.2012 April 2012 ASC
01.24.2012 January 2012 ASC 01.24.2012 January 2012 ASC
10.19.2011 October 2011 ASC 10.19.2011 October 2011 ASC
07.22.2011 July 2011 ASC 07.22.2011 July 2011 ASC
04.21.2011 April 2011 ASC 04.21.2011 April 2011 ASC
01.28.2011 January 2011 ASC 01.28.2011 January 2011 ASC
12.2010 October 2010 ASC 12.2010 October 2010 ASC
08.2010 July 2010 ASC 08.2010 July 2010 ASC
05.2010 April 2010 ASC 05.2010 April 2010 ASC
01.2010 January 2010 ASC 01.2010 January 2010 ASC
10.2009 October 2009 ASC 10.2009 October 2009 ASC
08.2009 July 2009 ASC 08.2009 July 2009 ASC
04.2009 April 2009 ASC 04.2009 April 2009 ASC
01.2009 January 2009 ASC 01.2009 January 2009 ASC
10.2008 October 2008 ASC 10.2008 October 2008 ASC
01.2008 January 2008 ASC 01.2008 January 2008 ASC

Provider Notices 2010–

2017

03/07/2017   Reminder: Billing for Services in ASCs

2016

07.18.2016 Changes to Member Cost Share Update
07.05.2016 PA For Botox No Longer Required
07.05.2016 Circumcision Prior Authorization Changes
05.19.2016 Changes to Member Cost Share
04.07.2016 Montana Plan First - IUD and Anesthesia Updates
02.01.2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
01.15.2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01.19.2016

2015

12.31.2015 Changes to Montana Medicaid
11.23.2015 Prior Authorization Requests and Medical-Surgical Prior Authorization Request Form Rev. 12.2015
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

2014

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

2013

12.23.2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Update
11.26.2013 ICD-10 Readiness
09.11.2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes
05.28.2013 DPHHS to Discontinue Temporary Hotline Number
02.19.2013 Montana Medicaid HIPAA Operating Rules Upgrade

 2012

12.26.2012 Medicaid/HMK Plus Toll-Free Number
08.22.2012 Deleted ICD-9-CM Codes
01.06.2012 Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Start Date Must Match Admission Date

2011

11.07.2011 Provider Information on HIPAA 5010 837 Health Care Claim Transactions
11.04.2011 Meeting the Requirements of HIPAA 5010 When Reporting National Drug Codes on Electronic 837I and 837P Transactions Updated 11.16.2011
10.07.2011 Influenza Virus Vaccine
09.09.2011 HIPAA 5010.OCR Qualifier Changes Effective January 1, 2012
09.07.2011 Payment Error Rate Measurement (PERM)
07.18.2011 Reimbursement Changes for Covered Ancillary Services Provided to Youth in a PRTF and Additional Ancillary Services Are Covered
06.27.2011 HIPAA 5010.OCR Qualifier Changes Effective January 1, 2012
04.12.2011 Request: Claims Submission, Date of Payment by June 30, 2011
03.23.2011 Changes to Procedure Code Indicators

2010

11.22.2010 Enhanced Claims Editing – Add-On Codes
10.05.2010 Changes to NCCI Edits
07.28.2010 Provider Record Update Procedures
06.23.2010 Cost Sharing Exemption under ARRA
06.22.2010 Electronic Health Records Link
02.09.2010 United States 2010 Census

Provider Notices 2001–2009

2009

10.01.2009 Healthy Montana Kids Plan
09.22.2009 NDC Billing Tools
04.28.2009 Ambulatory Surgical Center Payment System
04.27.2009 Transplant Program Update 04.30.2009
03.16.2009 Timely Filing for Medicare Crossovers
03.05.2009 Vagus Nerve Stimulation (VNS) 03.10.2009
02.12.2009 Reimbursement Change for Psychiatric Residential Treatment Facilities and How It Affects Other Montana Medicaid Providers

2008

10.20.2008 Changes in Transplant Coverage 10.27.2008
08.12.2008 Federal Government May Request Medical Records 09.18.2008
07.22.2008 Billing Procedures Regarding Electronic Claims (837P and 837I)
05.29.2008 When to Submit an NDC (National Drug Code) If You Are Billing as a 340B Provider
05.22.2008 Frequently Asked Questions About NPI Reenrollment and Billing 06.17.2008
04.10.2008 Billing Procedures Regarding National Drug Code (NDC) for Providers Using the CMS-1500 and 837-P
03.17.2008 Resubmission of Denied Claims 03.19.2008
03.11.2008 Billing Procedures Regarding National Drug Code (NDC) 10.15.2008
03.10.2008 NPI Reenrollment and Billing
02.20.2008 Changes to Prior Authorization for Circumcision 08.05.2008
02.19.2008 New HCPCS and CPT Codes
02.04.2008 Duplicate Issue Updated from 01.31.2008
01.18.2008 Possible Duplicate Claims Processed Through Electronic Data Interchange

2007

12.26.2007 WINASAP Upgrade Required for NDC Data Collection
12.17.2007 Enhanced Claims Editing – Assistant, Team, Co-Surgeon
12.17.2007 Enhanced Claims Editing – Multiple Evaluation and Management Services Provided on the Same Day
12.03.2007 NDC Requirement on All Physician-Administered Drugs 01.17.2008
12.03.2007 NPI Requirement for Fee-for-Service Healthcare Provider Claims
11.27.2007 Cost Share Changes
11.01.2007 Enhanced Claims Editing – Add-On Codes
11.01.2007 Enhanced Claims Editing – New Visit Evaluation and Management Codes
11.01.2007 Enhanced Claims Editing Bloodhound ClaimsGuard®
08.01.2007 Elimination of eSOR
06.25.2007 NPI on the Web Portal
06.11.2007 Ownership and Control Information Required for Reenrollment
05.31.2007 New CMS-1500 to Be Required Beginning July 2, 2007
03.08.2007 New and Deleted Codes

2000–2006

12.08.2006 Changes to ASC Payment Rates
02.10.2006 New and Deleted Codes
07.28.2005 Scales – Congestive Heart Failure
03.01.2005 Hysterectomy Acknowledgement Update
02.04.2005 Introduction to Preferred Drug List
02.01.2005 New and Deleted Codes and New Botox Criteria
06.10.2004 Team Care Program A New Component of the Passport to Health Program
06.01.2004 Important Reminder Regarding Sterilizations, Hysterectomies and Abortions
02.01.2004 New and Deleted Codes
12.01.2003 Expanded Botox Criteria
08.29.2003 Passport to Health Implementation in Prairie County
08.29.2003 DMEPOS Advisory Workgroup Openings
08.20.2003 Submitting HIPAA Compliant Claims – Information for All Providers
06.01.2003 Discontinued Services That Now Require Prior Authorization
05.12.2003 Provider Rate and Payment Update
04.30.2003 Gastric Bypass Surgeries and Circumcisions
03.01.2003 Pharmacy Prior Authorization and Refill Changes
03.01.2003 New and Deleted HCPCS and CPT Codes
01.29.2003 Prescription Drug Update
01.15.2003 Dental Program Changes
01.10.2003 New Provider Notification Procedure and Medicaid Changes
01.02.2003 Prior Authorization Updates
10.01.2002 Billing for Medicare Crossovers After Medicare's 45-Day Response Time
09.01.2002 Cost Sharing
07.01.2002 2.6% Reduction
06.20.2002 Passport to Health 24-Hour Availability
02.14.2002 Weekly Payment Available
10.17.2001 Dental Implants

Other Resources

Prior Authorization Criteria for Specific Services

EOB R&R Crosswalk and EOB R&R Crosswalk 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.

Rebateable Manufacturers 01/2017

SURS Provider Self-Audit Protocol 10.2015

The TPL Carrier Code List has been removed from this website, for questions or concerns related to the document please contact mttpl@xerox.com. Thank you.