Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Dental (Dentist and Dental Hygienist)

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Dental (Dentist and Dental Hygienist)


Dentist and Dental Hygienist

Provider Manuals

General Information for Providers  09/2017

Medicaid manual with general information for all provider types.

Dental and Denturist Services 08/2017

This manual has information specific to your provider type.

Healthy Montana Kids (HMK) and CHIP Dental Services 08/2017

This manual has information specific to HMK and CHIP dental providers.

Medicaid Rules and Regulations

Fee Schedules – Dentist

07/2016 PDF July 2016 Dental Excel July 2016 Dental
01/11/2016 PDF January 2016 Dental Excel January 2016 Dental
07/2015  PDF July 2015 Dental Excel  July 2015 Dental
07/2014 PDF July 2014 Dental Excel July 2014 Dental

Fee Schedules – Dental Hygienist

Provider Notices


09/14/2017 Montana Plan First Anesthesia Update
08/30/2017 PA for Dental General Anesthesia
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
04/06/2017 New EPSDT Request Form


07/16/2016 Changes to Member Cost Share Update
06/09/2016 Dental Reimbursement Rate Change and Updated provider Manual
05/19/2016 Changes to Member Cost Share
02/01/2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
01/21/2016 Important Dental Benefit Update
01/15/2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01/19/2016


12/31/2015 Changes to Montana Medicaid
12/31/2015 Important Dental Benefit Update
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
08/07/2015 Identification of Referring Providers on ADA Claim Form and 837D X12 Transactions
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
07/13/2015 Dental Reimbursement Rate Change and Updated Provider Manual
02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU


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
08/22/2014 Tobacco Cessation Products
08/05/2014 Montana Prescription Drug Registry
07/01/2014 Dental Reimbursement Rate Change, Updated Provider Manual, New and Discontinued Procedure Codes, and New Dental Claim Form
06/17/2014 Healthy Montana Kids (HMK)/CHIP Dental Changes
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

Other Resources

Certification Training for Dentists to add the Access to Baby and Child Dentistry Specialty Endorsement
Dental Provider MDA Training Materials 05/2017

Dental Emergency Services Form 07/2013
This form must be completed and submitted with claims for emergency dental services provide to members age 21 and over with Basic Medicaid coverage.

Sample ADA Dental Claim Form 06/2016

SURS Provider Self-Audit Protocol 10/2015

To locate older documents, access the Archive Page.