Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Psychologist

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Psychologist

Psychologist

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Mental Health Services – Adult 03/2017

This manual has information specific to your provider type.

Mental Health Services – Children 10.2015

This link brings you to Manuals and Guides on the Department website.

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

 

Mental Health - Adult

2017

03/16/2017 In summary, some minor changes were made to language on the code chart on page 10.

 

08.26.2016 In Summary, the Cost Share section on pages 4 and 5 was removed and replaced with a referral to the general manual, and the index was adjusted to reflect impacted page numbers.

06.08.2016

Mental Health - Adult July 2016

In summary, the Cover Page date was changed and the Index was amended to replace  “Basic” and “Full” Medicaid to “Standard Medicaid”.

 

Medicaid Rules and Regulations

Fee Schedules – 72-Hour Presumptive

Fee Schedules – Medicaid Mental Health

Fee Schedules – Mental Health Services Plan (MHSP)

Provider Notices 2010–

2017

04/06/2017 New EPSDT Request Form
02/07/2017 New Place of Service for Telehealth

2016

12/15/2016 Billing and Code Clarification for Psychotherapy and Psychiatric Diagnostic Services
11/01/2016 ICD 10 Updates and Coding Changes Revised 12/07/2016
08.12.2016 Vaccine Administration by Pharmacists
08.12.2016 Removal of 15-day Supply Limit on Initial Atypical Antipsychotic Prescriptions
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 Benefit
01.15.2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01.19.2016

2015

12.31.2015 Changes to Montana Medicaid
12.30.2015 Addictive and Mental Disorders Division Changes to Prior Authorization
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
08.10.2015 Requesting Additional Therapy Sessions and Exception to 24 Sessions Request Form
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
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
12.01.2014 Billing and Code Clarification for Individual and Family Therapy on the Same Day
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
02.06.2014 Interactive Audio and Video Mental Health Services for Licensed Psychologists, LCPCs, and LCSWs
01.29.2014 Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Readiness Assessment Update
01.28.2014 SmartPA® Prior Authorization for All Preparations to Treat Head Lice
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

2013

12.23.2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Update
11.26.2013 ICD-10 Readiness
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)
07.10.2013 Psychiatrist Service Reimbursement Change and Timely Billing Requirement
07.08.2013 Montana Medicaid DSM-5 Implementation
06.28.2013 PRTF Montana-CANS Implementation
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
12.17.2012 American Medical Association Adopts New Psychiatric Diagnostic and Psychological Codes
08.22.2012 Deleted ICD-9-CM Codes
06.11.2012 Plan First Effective 06.01.2012
01.06.2012 Smoking and Tobacco Use Cessation Counselor Services
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 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
06.24.2011 PRTF Waiver Site Denial Required
06.01.2011 17-AHP and Makena
04.12.2011 Request: Claims Submission, Date of Payment by June 30, 2011
02.07.2011 Vaccine Administration Code Update

2010

11.17.2010 17-AHP
11.17.2010 Compound Drugs Billed on a CMS-1500
10.05.2010 Changes to NCCI Edits
07.28.2010 Provider Record Update Procedures
07.15.2010 Vaccine Update Effective February 23, 2010
06.23.2010 Cost Sharing Exemption under ARRA
06.23.2010 Changes to the First Health Services Provider Manuals, Clinical Guidelines and Forms Used for Utilization Management of Children's Mental Health Medicaid Services
06.23.2010 Resource-Based Relative Value Scale (RBRVS) Information
06.22.2010 Electronic Health Records Link
05.28.2010 Clinical Laboratory Fee Schedule (CLFS) Instructions for Test Codes 80100, 80101, 80101 QW, G0430, G0430 QW, and G0431 QW
02.11.2010 Family Planning Clinic Billing Opportunity Will Expire on August 1, 2010
02.09.2010 United States 2010 Census
01.21.2010 Reimbursement Change for Psychiatric Residential Treatment Facilities and How It Affects Other Montana Medicaid Providers

Provider Notices 2002–2009

2009

12.10.2009 Billing and Code Clarification for Psychological Testing and Request to Adjust Claims by December 31, 2009
10.08.2009 2009 H1N1 Influenza Vaccine and Administration 10.15.2009
10.01.2009 Healthy Montana Kids Plan
09.22.2009 NDC Billing Tools
07.28.2009 Family Planning Clinic Medicaid Billing Changes
06.02.2009 Clarification of Required NDC Information for Coverage of 17 Alpha-Hydroxyprogesterone Caproate (17-AHP)
03.16.2009 Timely Filing for Medicare Crossovers
02.25.2009 Vaccines for Children (VFC) Effective as of October 10, 2008
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)
07.11.2008 Changes in Mental Health Services Plan for Adults Age 18 and Older
07.10.2008 Multiple Conversion Factors for RBRVS Providers
07.10.2008 Multiple Conversion Factors for RBRVS Providers
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
02.19.2008 New HCPCS and CPT Codes
01.18.2008 Possible Duplicate Claims Processed Through Electronic Data Interchange
01.11.2008 Vaccines for Children (VFC)

2007

12.28.2007 New Codes for Smoking and Tobacco Use Cessation Counseling
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 NPI Requirement for Fee-for-Service Healthcare Provider Claims
11.30.2007 NDC Requirement on All Physician-Administered Drugs 01.17.2008
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®
10.03.2007 VFC Update
09.28.2007 Smoking and Tobacco Use Cessation Counseling
08.01.2007 Elimination of eSOR
07.06.2007 Coverage of 17 Alpha-Hydroxyprogesterone Caproate
06.25.2007 NPI on the Web Portal
06.11.2007 Ownership and Control Information Required for Reenrollment
06.06.2007 NPI Contingency Plan Implemented, Reenrollment Extended
05.31.2007 New CMS-1500 to Be Required Beginning July 2, 2007
04.16.2007 VFC Update Updated from 01.24.2007
04.16.2007 Coverage of HPV Vaccine
03.08.2007 New and Deleted Codes

2006

12.22.2006 Prior Authorization for DMEPOS and Medical and Surgical Procedures Updated Phone and Fax Lines
11.08.2006 Prior Authorization on the Move
09.22.2006 VFC Update
04.18.2006 VFC Update
03.01.2006 VFC Update
02.10.2006 New and Deleted Codes
01.05.2006 Increased Reimbursement for EPSDT Preventive Services

2002–2005

09.26.2005 Blood Draws (CPT 36415 and 36416)
09.22.2005 Telemedicine
07.28.2005 Scales – Congestive Heart Failure
07.01.2005 VFC Update
06.01.2005 Medicaid Coverage 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
02.01.2004 New and Deleted Codes
01.01.2004 VFC Changes Updated from 12.2003
12.01.2003 High-Risk Pregnant Women (HRPW) Changes
12.01.2003 Bilateral X-Ray Reimbursement Update
12.01.2003 Expanded Botox Criteria
12.01.2003 VFC Changes
12.01.2003 Discontinued Local Codes
11.10.2003 EMTALA Policy Change
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
05.12.2003 Provider Rate and Payment Update
03.01.2003 Pharmacy Prior Authorization and Refill Changes
03.01.2003 New and Deleted HCPCS and CPT Codes
01.29.2003 Prescription Drug Services Update
01.10.2003 New Provider Notification Procedure and Medicaid Changes
12.01.2002 Program Changes and Updates
10.01.2002 Billing for Medicare Crossovers After Medicare's 45-Day Response Time
09.26.2002 DME Update
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

Other Resources

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.
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.