Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Family Planning

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Family Planning

Family Planning

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

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

Physician-Related Services

11/28/0216 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.
09/12/2016 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.
08.31.2016 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.
07.31.2015 Physician-Related Services, August 2015: Entire Manual, Removed EPSDT Well-Child
07.08.2014 Physician-Related Services, July 2014: Multiple Chapters

Passport to Health

11.09.2015 Passport to Health, November 2015: Passport Referrals

Medicaid Rules and Regulations

Fee Schedules – Family Planning

Family Planning Fee Schedule Information
Payment of Family Planning services is based on the fee schedule for the provider type performing the service. If the member has Medicaid, please review the fee schedule for the specific provider type performing the service to determine whether the service is covered.

If the member has Plan First coverage, please review the Service Code List found on the Plan First Page http://medicaidprovider.mt.gov/planfirst.
Plan First is subject to all Montana Medicaid fees and policies.

07/2015 July 2015 Family Planning PDF

01/2015 January 2015 Family Planning

01/2015 January 2015 Family Planning

07/2014 July 2014 Family Planning

07/2014 July 2014 Family Planning

02/2014 January 2014 Family Planning

02/2014 January 2014 Family Planning

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
05/01/2017 Vaccine Administration Code Update
04/20/2017  Plan First Hysterectomy codes added effective April 1, 2017
04/06/2017 New EPSDT Request Form
02/02/2017 EPSDT ( Children's) Lead Screening Requirements

2016

11/10/2016 Vaccines For Children Administration Update
07/28/2016 Montana Plan First Preventive Code Additions
07/18/2016 Changes to Member Cost Share Update
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
11/03/2015 Services Exempt from Passport to Health Referral
10/09/2015 Montana Plan First – ICD-10 Update
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
07/08/2015 Montana Plan First – Revised List of Plan First Covered Services
06/19/2015 Vaccine Administration Code Update
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
10/08/2014 Vaccine Administration Code Update
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
03/18/2014 Information Regarding CMS-1500
01/29/2014 Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Readiness Assessment Update
01/28/2014 Vaccine Administration Code 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 discontinued the use of Medicaid EOB codes and began using HIPAA standard reason and remark (R&R) codes. This document crosswalks the HIPAA standard R&R codes to the Medicaid EOB codes.

Plan First Medicaid Non-Covered Agreement 07/2012

Rebateable Manufacturers 04/2017

SURS Provider Self-Audit Protocol 10/2015

To locate older documents, access the Archive Page.