Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Ambulatory Surgical Center

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Ambulatory Surgical Center

Ambulatory Surgical Center

Provider Manuals

General Information for Providers  09/2017

Medicaid manual with general information for all provider types.

Ambulatory Surgical Center Services 08/2017

This manual has information specific to your provider type.

Medicaid Rules and Regulations

Fee Schedules – Ambulatory Surgical Center (ASC)

Some documents on this page are legal and/or historical in nature and cannot be altered to meet 508 Accessibility standards.  Each of those documents has a corresponding .txt document with the same name placed next to it.

January 2018

ASC Coversheet January 2018
ASC Fee Schedule January 2018 PDF    
ASC Fee Schedule January 2018 Excel

October 2017

PDF: ASC Fee Schedule October 2017 Cover Sheet: ASC Fee Schedule Cover Sheet
Excel: ACS Fee Schedule October 2017 Excel

July 2017

PDF: ACS Fee Schedule July 2017 PDF Cover Sheet: ACS Fee Schedule Cover Sheet
Excel: ACS Fee Schedule July 2017 Excel

April 2017 

PDF: ASC Fee Schedule Definitions
PDF: ACS Fee Schedule April 2017 PDF 
Excel: ACS Fee Schedule April 2017 Excel

January 2017

PDF: January 2017 ASC
Excel: January 2017 ASC
TXT: January 2017 ASC

October 2016

PDF: October 2016 ASC
Excel: October 2016 ASC
TXT: October 2016 ASC

July 2016 

PDF: July 2016 ASC Rev. 08/05/2016
Excel: July 2016 ASC Rev. 08/05/2016
TXT: July 2016 ASC Rev. 08/05/2016

April 2016

PDF: April 2016 ASC
Excel: April 2016 ASC
TXT: April 2016 ASC

January 2016

PDF: January 2016 ASC
Excel: January 2016 ASC
TXT: January 2016 ASC

October 2015 

PDF: October 2015 ASC
Excel: October 2015 ASC
TXT: October 2015 ASC

July 2015

PDF: July 2015 ASC
Excel: July 2015 ASC
TXT: July 2015 ASC

April 2015 

PDF: April 2015 ASC
Excel: April 2015 ASC
TXT: April 2015 ASC

January 2015

PDF: January 2015 ASC
Excel: January 2015 ASC
TXT: January 2015 ASC

Provider Notices

Some documents on this page are legal and/or historical in nature and cannot be altered to meet 508 Accessibility standards.  Each of those documents has a corresponding .txt document with the same name placed next to it.

2017

12/29/2017 Prior Authorization for Transgender Mastectomy/Breast Augmentation
12/29/2017 Prior Authorization for Gender Reassignment Surgery
12/26/2017 MATH Web Portal Eligibility Inquiry Verification Update
12/11/2017  Montana Plan First Procedure and Service Codes - Contraceptive (IUD) Update
12/01/2017 Montana Medicaid Expansion Prior Authorization Changes
11/20/2017 Qualified Medicare Beneficiary (QMB) Claim Adjustments
11/02/2017 New Medicare Card
10/02/2017 Montana Medicaid Expansion Changes
09/14/2017 Montana Plan First Anesthesia Update
08/21/2017 Clinical Pharmacist Practitioner
08/01/2017 Telemedicine - Correction
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

PDF: 07/18/2016 Changes to Member Cost Share Update
TXT:  07/18/2016 Changes to Member Cost Share Update
PDF: 07/05/2016 PA For Botox No Longer Required
TXT:  07/05/2016 PA For Botox No Longer Required
PDF: 07/05/2016 Circumcision Prior Authorization Changes
TXT:  07/05/2016 Circumcision Prior Authorization Changes
PDF: 05/19/2016 Changes to Member Cost Share
TXT:  05/19/2016 Changes to Member Cost Share
PDF: 04/07/2016 Montana Plan First - IUD and Anesthesia Updates
TXT:  04/07/2016 Montana Plan First - IUD and Anesthesia Updates
PDF: 02/01/2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
TXT:  02/01/2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
PDF: 01/15/2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01/19/2016
TXT:  01/15/2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01/19/2016

2015

PDF: 12/31/2015 Changes to Montana Medicaid
TXT:  12/31/2015 Changes to Montana Medicaid
PDF: 11/23/2015 Prior Authorization Requests and Medical-Surgical Prior Authorization Request Form Rev. 12/2015
TXT:  11/23/2015 Prior Authorization Requests
PDF: 11/03/2015 Services Exempt from Passport to Health Referral
TXT:  11/03/2015 Services Exempt from Passport to Health Referral
PDF: 10/01/2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
TXT:  10/01/2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
PDF: 08/03/2015 ICD-10 Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10)
TXT:  08/03/2015 ICD-10 Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10)
PDF: 07/31/2015 Adult and Pediatric Specialty Table of Services Available in Montana
TXT:  07/31/2015 Adult and Pediatric Specialty Table of Services Available in Montana
PDF: 06/09/2015 National Drug Code (NDC) Billing
TXT:  06/09/2015 National Drug Code (NDC) Billing
PDF: 02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU
TXT:  02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU

Other Resources

To locate older documents, access the Archive Page.