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Durable Medicaid Equipment, Prosthetics, Orthotics, and Supplies


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) 05/2017

This manual has information specific to your provider type.

Medicaid Rules and Regulations

Fee Schedules – Durable Medical Equipment (DME)


08/27/2015 PDF July 2015 DME Rev. Excel July 2015 DME Rev.
03/10/2015 PDF January 2015 DME Rev. Excel January 2015 DME Rev.
10/2014 PDF October 2014 DME Rev. Excel October 2014 DME Rev.
07/2014 PDF July 2014 DME Excel July 2014 DME
02/2014 PDF January 2014 DME Excel January 2014 DME

Provider Notices


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


11/10/2016 Insulin Pump PA Removal
09/26/2016 Coverage of Weighted Blankets
07/18/2016 Changes to Member Cost Share Update
05/19/2016 Changes to Member Cost Share
04/07/2016 Montana Plan First - IUD and Anesthesia Updates
03/21/2016 HCPCS Code For Ventilators E0465 and E0466
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
01/15/2016 Hospital Grade Electric Breast Pump Requirements


12/31/2015 Changes to Montana Medicaid
11/27/2015 Home Blood Glucose Monitors and Related Accessories and Supplies
11/13/2015 Oral Nutrition for Children Under Age 21 – EPSDT
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
06/22/2015 Identification of Ordering and Referring Providers on CMS-1500 and 837P X12 Transactions
04/27/2015 Children’s (EPSDT) Coverage Criteria for Specified DME
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
12/08/2014 Compression Garments for the Legs
11/24/2014 DME Order and Prescription Requirements
11/05/2014 Gastrostomy/Jejunostomy Tube – Code B4088
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
08/05/2014 Montana Prescription Drug Registry
07/14/2014 Home Blood Glucose Monitors and Related Accessories and Supplies
06/26/2014 Terminology Change Regarding Method of Payment
06/24/2014 HMK (Formerly CHIP) Diabetic Supplies
06/12/2014 ICD-10 Delay
05/13/2014 PERM Provider Educational Webinars
04/22/2014 Modifier Changes for Professional Claim Billers
03/27/2014 Home Blood Glucose Monitors and Related Accessories and Supplies Update
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

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

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