Rural Health Clinic RHC Rural Health Clinic Provider Manuals General Information for Providers 02/2017 Medicaid manual with general information for all provider types. Rural Health Clinic 07/2016 This manual has information specific to your provider type. Prescription Drug Program, Prior Authorization Chapter 01/2016 Prior authorization requirements and procedures are covered in this chapter. Passport to Health 11/2015 Everything a provider needs to know to become a successful Passport provider. 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 The Introduction contains updated links in the HELP section. Cost Share was updated in the Billings Procedure. A duplicate word was removed in the RA chapter. The Cover Page was changed to reflect the current date of the new General Manual revision. 07.12.2016 General Information For Providers, July 2016 Table of Contents was amended by changing the title of “Basic Medicaid Waiver” to “Waiver for Additional Services and Populations (formerly Basic Medicaid Waiver)”. Index was amended by changing the title of “Basic Medicaid Waiver” to “Waiver for Additional Services and Populations (formerly Basic Medicaid Waiver)”. Page 1.3 changed the title “Basic Medicaid Waiver for Additional Services and Populations” to “Waiver for Additional Services and Populations (formerly Basic Medicaid Waiver)” 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, October 2014: Billing Procedures 07.22.2014 General Information for Providers, July 2014: Member Eligibility and Responsibilities 06.30.2014 General Information for Providers, June 2014 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 Rural Health Clinic 07.27.2016 RHC_FQHC Manual, July 2016. In summary. the Cost share section was updated in the Billing Procedures chapter and the Cover Page was updated to reflect the correct date. 12.31.2015 RHC Manual, January 2016: HELP Plan-Related Updates and Others 08.25.2015 RHC Manual Changes in the Introduction, Covered Services, Prior Authorization, Billing Procedures, Submitting a Claim, and the How Payment Is Calculated chapters. 04.29.2015 RHC Manual 10.29.2013 RHC, Key Contacts, Covered Services, Billing Procedures, Submitting a Claim, RAs and Adjustments 07.05.2013 RHC, Other Programs These replacement pages also includes a terminology change (client to member). Unless a paragraphs also included content changes, it is not marked as a change but is included in this document. 03.22.2013 Coordination of Benefits 07.20.2011 RHC Services (Entire Manual) 08.24.2007 Key Contacts, Prior Authorization, Coordination of Benefits, and Revised Revenue Codes Passport to Health 11.09.2015 Passport to Health, November 2015: Passport Referrals Medicaid Rules and Regulations Code of Federal Regulations (Title 42) Montana Code Annotated (Title 53, Chapter 6) Administrative Rules of Montana (Title 37) Chapter 79 Healthy Montana Kids Chapter 82 Medicaid Eligibility Chapter 83 Medicaid for Certain Medicare Beneficiaries and Others Chapter 85 General Medicaid Services Chapter 86 Medicaid Primary Care Services Provider Notices For prescription medication notices, see the Pharmacy page/ 2017 05/26/2017 Federal Final Rule, "Nondiscrimination in Health Program and Activities” and Implication for Coverage of Services Related to Gender Transition 05/01/2017 Vaccine Administration Code Update 04/20/2017 Plan First Hysterectomy codes added effective April 1, 2017 04/06/2017 New EPSDT Request Form 02/22/2017 Licensed Addiction Counselors added to definition of a health professional/core provider for FQHC and RHC 02/02/2017 EPSDT ( Children's) Lead Screening Requirements 2016 11/14/2016 Licensed Addiction Counselors (LAC) added to the added to thedefinition of a Health Professional/core provider for Montana MedicaidFQHC and RHC facilities/ 11/10/2016 Vaccines For Children Administration Update 07/28/2016 Montana Plan First Preventive Code Additions 07/18/2016 Changes to Member Cost Share Update 07/12/2016 Vaccine Administration Code Update 07/05/2016 PA For Botox No Longer Required 07/05/2016 Circumcision Prior Authorization Changes 05/19/2016 Changes to Member Cost Share 04/07/2016 Montana Plan First - IUD and Anesthesia Updates 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 10/09/2015 Montana Plan First – ICD-10 Update 10/01/2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual 08/19/2015 Identification of Ordering and Referring Providers on UB-04 and 837I X12 Transactions 08/17/2015 Medicare Crossover Claims With Medicare Non-Covered Charges That Medicaid Allows 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 07/08/2015 Montana Plan First – Revised List of Plan First Covered Services 06/26/2015 Vaccine Administrative Code Update 02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU 01/30/2015 Telehealth Diagnosis Codes 2014 12/18/2014 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Final Notice 11/25/2014 Telehealth 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 04/22/2014 Modifier Changes for Professional Claim Billers 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 Other Resources 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. Forms MHSP Clinical Eligibility Assessment Form 07/2009 MHSP Covered SDMI Diagnoses 07/2009 Plan First Medicaid Non-Covered Agreement 07/2012 SURS Provider Self-Audit Protocol 10/2015 To locate older documents, access the Archive Page.