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School-Based Services

School-Based Services

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

School-Based Services 07/2013

This manual has information specific to your provider type.




Provider Manuals – Replacement Pages

General Information for Providers

02/06/2017 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.





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
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

School-Based Services

07.10.2013 School-Based Services, May 2013: Entire Manual
These replacement pages includes a terminology change (client to member); however, unless a paragraphs also included content changes, it is not marked as a change.
04.27.2012 School-Based Services, April 2012: Covered Services
06.09.2011 School-Based Services, June 2011: Covered Services
09.16.2008 School-Based Services, April 2008: Key Contacts, Covered Services, Billing Procedures, and Claim Instructions
02.14.2007 School-Based Services, February 2007: Revised Physician Order Information, New Private Duty Nursing Request Form
04.25.2006 School-Based Services, April 2006: Coordination of Benefits Information
01.17.2006 School-Based Services, January 2006: Documentation Requirements, Restricted CSCT Services, Private-Duty Nursing Review Requirements, and School-Based Services Codes
10.06.2005 School-Based Services, August 2005: Covered Services and Billing Information for CSCT and Therapy
05.12.2005 School-Based Services, May 2005: Key Contacts and Place of Service
04.11.2005 School-Based Services, April 2005: Key Contacts
08.30.2004 School-Based Services, August 2004: Audiology Services Defined
04.26.2004 School-Based Services, April 2004: Key Contacts and Websites, Covered Services, COB, Billing Procedures, Claim Forms, RAs and Adjustments, Forms and Definitions
01.14.2004 School-Based Services, January 2004: Covered Services Error Correction
12.23.2003 School-Based Services, December 2003:CSCT Changes

Passport to Health

11.09.2015 Passport to Health, November 2015: Passport Referrals

Medicaid Rules and Regulations

Fee Schedules – School-Based Services

01/2017 PDF January 2017 Schools Excel January 2017 Schools
10/2016 PDF October 2016 Schools Excel October 2016 Schools
07/2016 PDF July 2016 Schools Excel July 2016 Schools
09/17/2015 PDF October 2015 Schools Excel October 2015 Schools
07/2015  PDFJuly 2015 Schools Excel July 2015 Schools
10/2014 PDF October 2014 Schools Excel October 2014 Schools
07/2014 PDF July 2014 Schools Excel July 2014 Schools                                  
02/2014 v January 2014 Schools Excel January 2014 Schools     

Fee Schedules – 72-Hour Presumptive

Fee Schedule - Medicaid Mental Health Adults 18 and Over

Fee Schedule - Medicaid Mental Health Youth Under 18

Fee Schedule - Mental Health Services Plan (MHSP) Adults 18 and Over

Mental Health Services Plan (MHSP) Adults 18 and Over

07/01/2016 July 2016 MHSP for Adults

12/17/2015 January 2016 MHSP for Adults Rev. 12/24/2015

07/2015 July 2015 MHSP for Adults

07/2014 July 2014 MHSP for Adults




Fee Schedule - Mental Health Services Plan (MHSP) Youth Under 18

Mental Health Services Plan (MHSP) Youth Under 18

06/08/2016 July 2016 Medicaid Mental Health for Youth

Provider Notices


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
02/02/2017 EPSDT ( Children's) Lead Screening Requirements
01/03/2017 New Guidelines for Outpatient Psychotherapy


11/01/2016 ICD 10 Updates and Coding Changes Revised 12/07/2016
10/03/2016 FMAP Rate Reflect Change to Reimbursement on the Fee Schedule
07/18/2016 Changes to Member Cost Share Update
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


12/31/2015 Changes to Montana Medicaid
11/03/2015 Services Exempt from Passport to Health Referral
11/02/2015 CSCT Claims Issues Related to Updated Severe Emotional Disturbance (SED) Definition
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
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
10/06/2014 2015 FMAP Rate Reflects Changes to Reimbursement on the Fee Schedule
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
06/27/2014 Reimbursement Rate Changes and Terminology Change Regarding Method of Payment 06/12/
2014 ICD-10 Delay 05/13/2014 PERM Provider Educational Webinars
05/05/2014 CSCT Requirement
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

Medicaid Administrative Claiming (MAC)

School Based ICD-10, Direct Care, and MAC 09/21/2015
This training applies to School Based service providers and the need to start coding ICD-10 diagnosis codes for October 1, 2015, dates of service forward. Refresher on Direct Care and MAC services are also included.
MAC Training (Coordination and Financial Officers) 03/2015
MAC Agreement Memorandum of Understanding 03/2015
This is the agreement that needs to be signed by the district representative and the state Medicaid Administrator in order for your district to participate in the Medicaid Administrative Claiming Program.
MAC Coordinators' Guide 03/2015
This guide provides a program overview for the person responsible for overseeing the implementation of the MAC program in the district or cooperative. It details how to prepare the participant listing, training time study participants, and managing the time study observation forms.
MAC Financial Data Guide 03/2015
This guide details the requirements for the financial data report necessary for submitting district expenditures in support of Medicaid services. MAC Time Study Guide 03/2015
This guide provides time study participants information and guidelines on how to complete the Random Moment Sample Time Study Observation forms. It gives details and examples of the activity codes. MAC Time Study Participant Training 03/2015
This presentation is designed to train the staff who will be participating in the RMS Time Study.

Participant Training Quiz 03/2015
This quiz can be used at the end of your training session to help participants code activities. It can be used individually or as a group discussion. This paper can also serve as your documentation of training to keep in your audit file.

Participant Training Quiz with Answers 03/2015

MAC Activity Code Reference Guide and Definitions 03/2015
This guide gives a detailed description of each activity code and provides examples of when the code should be used. Coordinators will find this useful when checking over the observation forms. This one-page definition of the activity codes should be copied onto the back of every Random Moment Observation form. It gives examples of when to use each activity code.
SURS Provider Self-Audit Protocol 10/2015

To locate older documents, access the Archive Page.