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 2010–

2017

04/06/2017 New EPSDT Request Form
04/05/2017 New Form to Document Need for Orthognathic Surgery

2016

07.18.2016 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
01.15.2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01.19.2016

2015

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

08.03.2015 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

2014

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

08.05.2014 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

01.09.2014 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

09.11.2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes

06.25.2013 Dental Reimbursement Rate Change, Updated Provider Manual, New Procedure Code, and New Prior Authorization Treatment Plan Form for Orthodontia

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

08.22.2012 Deleted ICD-9-CM Codes

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

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

05.18.2011 Dental and Denturist Program Manual Updated

04.12.2011 Request: Claims Submission, Date of Payment by June 30, 2011

2010

10.05.2010 Changes to NCCI Edits

07.28.2010 Provider Record Update Procedures

06.23.2010 Cost Sharing Exemption under ARRA

06.22.2010 Electronic Health Records Link

06.04.2010 Medicaid Consultation Services

02.09.2010 United States 2010 Census

02.09.2010 Dental and Denturist Manual and Fee Schedules

Provider Notices 2000–2009

2009

2008

2007

2003–2005

2000–2002

Other Resources

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 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.