Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Durable Medicaid Equipment, Prosthetics, Orthotics, and Supplies

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Durable Medicaid Equipment, Prosthetics, Orthotics, and Supplies

DMEPOS

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies

Provider Manuals

General Information for Providers  09/2017

Medicaid manual with general information for all provider types.

Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies (DMEPOS) 10/2017

This manual has information specific to your provider type.

Medicaid Rules and Regulations

Fee Schedules – Durable Medical Equipment (DME)

Some documents on this page are legal and/or historical in nature and cannot be altered to meet 508 Accessibility standards.  Each of those documents has a corresponding .txt document with the same name placed next to it.

July 2015

PDF: July 2015 DME Rev. 03/10/2015
Excel: July 2015 DME Rev. 03/10/2015
TXT: July 2015 DME Rev. 03/10/2015

January 2015

PDF: January 2015 DME
Excel: January 2015 DME
TXT: January 2015 DME

Provider Notices

Some documents on this page are legal and/or historical in nature and cannot be altered to meet 508 Accessibility standards.  Each of those documents has a corresponding .txt document with the same name placed next to it.

2017

11/20/2017 Qualified Medicare Beneficiary (QMB) Claim Adjustments
11/02/2017 New Medicare Card
10/22/2017 S1040 - Cranial Remolding Orthotic
10/02/2017 Montana Medicaid Expansion Changes
09/14/2017 Montana Plan First Anesthesia Update
08/31/2017 S1040 Cranial Remolding Orthotic
08/21/2017 Clinical Pharmacist Practitioner
08/01/2017 Telemedicine - Correction
06/05/2017 Pulse Oximetry for Children Age 0-20
05/26/2017 Federal Final Rule, "Nondiscrimination in Health Program and Activities” and Implication for Coverage of Services Related to Gender Transition
04/21/2017 Bowel Management Program Supplies
04/17/2017 Prior Authorization for Insulin Pumps - E0784
04/06/2017 New EPSDT Request Form
03/31/2017  Ketone Test Strips - A4250 & A252
01/11/2017  New HCPCS Codes for Insulin Pump Supplies – A4224 & A4225

2016

PDF: 11/10/2016 Insulin Pump PA Removal
TXT:  11/10/2016 Insulin Pump PA Removal
PDF: 09/26/2016 Coverage of Weighted Blankets
TXT:  09/26/2016 Coverage of Weighted Blankets
PDF: 07/18/2016 Changes to Member Cost Share Update
TXT:  07/18/2016 Changes to Member Cost Share Update
PDF: 05/19/2016 Changes to Member Cost Share
TXT:  05/19/2016 Changes to Member Cost Share
PDF: 04/07/2016 Montana Plan First - IUD and Anesthesia Updates
TXT:  04/07/2016 Montana Plan First - IUD and Anesthesia Updates
PDF: 03/21/2016 HCPCS Code For Ventilators E0465 and E0466
TXT:  03/21/2016 HCPCS Code For Ventilators E0465 and E0466
PDF: 02/01/2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
TXT:  02/01/2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
PDF: 01/15/2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01/19/2016
TXT:  01/15/2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01/19/2016
PDF: 01/15/2016 Hospital Grade Electric Breast Pump Requirements
TXT:  01/15/2016 Hospital Grade Electric Breast Pump Requirements

2015

PDF: 12/31/2015 Changes to Montana Medicaid
TXT:  12/31/2015 Changes to Montana Medicaid
PDF: 11/27/2015 Home Blood Glucose Monitors and Related Accessories and Supplies
TXT:  11/27/2015 Home Blood Glucose Monitors and Related Accessories and Supplies
PDF: 11/13/2015 Oral Nutrition for Children Under Age 21 – EPSDT
TXT:  11/13/2015 Oral Nutrition for Children Under Age 21 – EPSDT
PDF: 11/03/2015 Services Exempt from Passport to Health Referral
TXT:  11/03/2015 Services Exempt from Passport to Health Referral
PDF: 10/01/2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
TXT:  10/01/2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
PDF: 08/03/2015 ICD-10 Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10)
TXT:  08/03/2015 ICD-10 Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10)
PDF: 07/31/2015 Adult and Pediatric Specialty Table of Services Available in Montana
TXT:  07/31/2015 Adult and Pediatric Specialty Table of Services Available in Montana
PDF: 06/22/2015 Identification of Ordering and Referring Providers on CMS-1500 and 837P X12 Transactions
TXT:  06/22/2015 Identification of Ordering and Referring Providers on CMS-1500 and 837P X12 Transactions
PDF: 04/27/2015 Children’s (EPSDT) Coverage Criteria for Specified DME
TXT:  04/27/2015 Children’s (EPSDT) Coverage Criteria for Specified DME
PDF: 02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU
TXT:  02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU

Other Resources

Noridian Administrative Services
Medicare's DME Administrative Services provider.
Prior Authorization Criteria for Specific Services Region D DMERC/CIGNA Medicare
The Durable Medical Equipment Regional Carriers (DMERC) website. DMERC processes Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) for Medicare.
Medicare Pricing, Data Analysis, and Coding (PDAC)
This website assists manufacturers and suppliers with DMEPOS billing and coding information. Can call toll-free 1-877-735-1326 or e-mail DME PDAC using their contact form. SURS Provider Self-Audit Protocol 10/2015

To locate older documents, access the Archive Page.