Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Oral Surgeon

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Oral Surgeon

Oral Surgeon

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Dental and Denturist Program 07/2016

This manual has information specific to your provider type.

Physician-Related Services 11/2016

This manual has information specific to your provider type.

Provider Manuals – Replacement Pages

General Information for Providers

02/17/2017 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

Dental and Denturist Program

06.08.2016 Dental and Denturist Services, July 2016

In summary the Cover Page had the date only changed, the Covered Services Limitations section had nearly all of pages 2.2 and 2.10 updated,  the Orthodontia Services and the Requirements Section had the fee cap amount updated on page 3.5.

12.31.2015 Dental and Denturist Services, January 2016, HELP Plan-Related Updates and Others

07.01.2015 Dental and Denturist Services, July 2015: Entire Manual

07.01.2014 Dental and Denturist Services, July 2014

The manual has been streamlined. Information found elsewhere is not repeated in this manual; instead, a link to the source of the information is provided.

07.01.2013 Dental and Denturist Program, July 2013

This set of replacement pages includes the entire manual. Content changes are indicated by the addition of a change bar (black line). For a complete manual without the change bars, see the Provider Manuals section at the top of this page.

05.18.2011 Dental and Denturist Program, April 2011: Covered Services and Limitations and Orthodontia Services and Requirements

07.01.2005 Dental and Denturist Program, July 2005: Updated Fees

09.02.2004 Dental and Denturist Program, August 2004: Added "Per Quadrant" Requirements to Codes D4240–D4261

07.01.2004 Dental and Denturist Program, July 2004: Covered Services Update

07.02.2003 Dental and Denturist Program: July 2003: Procedure Limits and Requirements Table

07.01.2002 Dental and Denturist Program, July 2002: Covered Services and Limitations and Billing Procedures

Physician-Related Services

 

11/28/2016 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

07.14.2008 Physician-Related Services, March 2008: Key Contacts, Completing a Claim Form, Prior Authorization, Billing for Immunizations

07.25.2006 Physician-Related Services, July 2006: Well-Child EPSDT Update

04.25.2006 Physician-Related Services, April 2006: Revised Instructions for Completing a Claim, Revised Information on How Cost-Sharing Affects Claim Payment

01.05.2006 Physician-Related Services, September 2005: New EPSDT, Hysterectomy Acknowledgement Form, Revised Information on Imaging Modifiers, Billing for Immunizations, and ER Visits for Clients Under Age 2

03.01.2005 Physician-Related Services, March 2005: Hysterectomy Acknowledgement Update

01.25.2005 Physician-Related Services, January 2005: Rule References Added, Updates to Covered Services, PA and Modifiers

11.16.2004 Physician-Related Services, November 2004: Updated Prescription Drug PA Criteria

09.15.2004 Physician-Related Services, September 2004: Team Care Added

06.16.2004 Physician-Related Services, July 2004: Clarification on Sterilizations, Hysterectomies, Abortions and HIPAA and Drug PA Update

12.23.2003 Physician-Related Services, December 2003: Immunizations, PA Criteria, Family Planning, and Using Modifiers

09.16.2003 Physician-Related Services, September 2003: Hysterectomies and Prescription Drug PA Update

08.20.2003 Physician-Related Services, June 2003: New Emergency Services Policy and Hard Card Information

07.28.2003 Physician-Related Services, Hysterectomy Requirements

06.01.2003 Physician-Related Services, New PA Requirements and Hysterectomy Information

01.02.2003 Physician-Related Services, January 2003: Prior Authorization

09.01.2002 Physician-Related Services, September 2002: Cost Sharing

Medicaid Rules and Regulations

Fee Schedules – Oral Surgeon

Provider Notices

Other Resources

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

EOB R&R Crosswalk in PDF Format and EOB R&R Crosswalk in Excel Format 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 code

Lab Panels 2007 01/2007
List of codes that make up lab panels for 2004–2007.

To locate older documents, access the Archive Page.