Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Eyeglasses

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Eyeglasses

Eyeglasses

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Optometric and Eyeglass Services 04/2017

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.

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

Optometric and Eyeglass Services

04/10/2017

Optometric and Eyeglass Services, April 2017
In summary, the manual was updated to include current cost share language and co-pays and basic accessibility changes were made as approved by the Manuals Committee in September 2016.

12.31.2015 Optometric and Eyeglass Services, January 2016, HELP Plan-Related Updates and Others
06.24.2015 Optometric and Eyeglass Services, May 2015: Entire Manual
There are pages that have no text changes; however, the page layout is different than the previous manual due to changes on previous pages.
08.11.2014 Optometric and Eyeglass Services Manual, July 2014: Entire Manual
Information contained in the General Information for Providers manual or found elsewhere on the website has been removed, and links to those sources are included.
05.19.2010 Optometric and Eyeglass Services Manual, May 2010: Key Contacts and Prior Authorization
04.25.2006 Optometric and Eyeglass Services Manual, April 2006: Covered Services Information for Initial/New Prescriptions for Eyeglasses
10.12.2005 Optometric and Eyeglass Services Manual, October 2005: Covered Services Information for Initial/New Prescriptions
09.09.2005 Optometric and Eyeglass Services Manual, August 2005: Eyeglass Service Modifiers, New Place of Service Codes
04.18.2005 Optometric and Eyeglass Services Manual, April 2005: Clarification for Lens Add-Ons and Updated Key Contacts
01.19.2005 Optometric and Eyeglass Services Manual, January 2005: Rule References Added
04.29.2004 Optometric and Eyeglass Services Manual, April 2004: Updates for HIPAA, Covered Services, and Billing Procedures
07.09.2003 Optometric and Eyeglass Services Manual, July 2004: Covered Services

Medicaid Rules and Regulations

Fee Schedules – Eyeglasses

PDF EXCEL

Please Note:

There is a posted proposed fee schedule (12/1/2016)  and related hearing announcement (10/13/2016)  for Eyeglasses on the Proposed Fee Schedules Page.

12/01/2016 December 2016 Eyeglasses Revised 12/15/2016 12/01/2016 December 2016 Eyeglasses Revised 12/15/2016
07/2010 July 2010 Eyeglasses  
12/2009 Dec 2009 Eyeglasses  
07/2009 July 2009 Eyeglasses  
07/2008 July 2008 Eyeglasses  
10/2007 October 2007 Eyeglasses  
07/2006 July 2006 Eyeglasses  
01/2006 January 2006 Eyeglasses  
07/2005 July 2005 Eyeglasses  
01/2005 January 2005 Eyeglasses  
07/2004 July 2004 Eyeglasses  
01/2004 January 2004 Eyeglasses  
07/2003 July 2003 Eyeglasses  
07/2002 July 2002 Eyeglasses  
01/2002 January 2002 Eyeglasses  

Provider Notices 2010–

2017

04/06/2017 New EPSDT Request Form

2016

11/28/2016 Walman Optical Fram Warranty Procedure
10/14/2016 Eyeglass Contractor Change
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

2015

12.31.2015 Changes to Montana Medicaid

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

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

11.18.2013 ICD-10 Readiness

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

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 01.01.2012

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

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

02.09.2010 United States 2010 Census

01.12.2010 Additional Optometric Lens Add-On

Provider Notices 2002–2009

2009

2008

2007

2000–2005

Other Resources

Eyewear FAQ  04/2017

EOB R&R Crosswalk PDF and EOB R&R Crosswalk Excel 02.2011

With the implementation of HIPAA, Medicaid discontinued the use of Medicaid EOB codes and began 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.