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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)

 

04/01/2017 ASC Fee Schedule Definitions PDF ACS Fee Schedule April 2017 PDF  Excel ACS Fee Schedule April 2017 Excel
01/17/2017 PDF   January 2017 ASC Excel January 2017 ASC
10/04/2016 PDF   October 2016 ASC Excel October 2016
07/01/2016  PDF  July 2016 ASC Rev. 08/05/2016 Excel July 2016 ASC Rev. 08/05/2016
04/05/2016 PDF   April 2016 ASC Excel April 2016 ASC
01/05/2016 PDF January 2016 ASC Excel January 2016 ASC
10/20/2015 PDF October 2015 ASC Excel October 2015 ASC
07/2015 PDF  July 2015 ASC Excel July 2015 ASC
05/04/2015 PDF April 2015 ASC Excel April 2015 ASC
01/20/2015  PDF January 2015 ASC Excel January 2015 ASC
10/07/2014 PDF October 2014 ASC Excel October 2014 ASC
09/24/2014  PDF July 2014 ASC Rev. 09/2014 Excel July 2014 ASC Rev. 09/2014
05/13/2014 PDF April 2014 ASC Excel April 2014 ASC
01/2014  PDF  January 2014 ASC Excel January 2014 ASC

 

 

Provider Notices

2017

05/26/2017 Federal Final Rule, "Nondiscrimination in Health Program and Activities” and Implication for Coverage of Services Related to Gender Transition 0
4/06/2017 New EPSDT Request Form
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

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
Rebateable Manufacturers 04/2017

SURS Provider Self-Audit Protocol 10/2015

To locate older documents, access the Archive Page.