Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Mental Health Center

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Mental Health Center

Mental Health Center

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Mental Health Services – Adult 03/2017

This manual has information specific to your provider type.

Mental Health Services – Children 10.2015

This link brings you to Manuals and Guides on the Department website.

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: Medicaid Covered Services and Client Eligibility

Mental Health - Adult

2017

03/16/2017 In summary, some minor changes were made to language on the code chart on page 10.

08.25.2016 In Summary, the Cost Share section on pages 4 and 5 was removed and replaced with a referral to the general manual, and the index was adjusted to reflect impacted page numbers.

06.08.2016

Mental Health - Adult July 2016

In summary, the Cover Page date was changed and the Index was amended to replace  “Basic” and “Full” Medicaid to “Standard Medicaid”.

   
   

 

Medicaid Rules and Regulations

Fee Schedules – 72-Hour Presumptive

Fee Schedules – HCBS for Adults with SDMI

Fee Schedules – Medicaid Mental Health

Adults 18 and Over

PDF
07.01.2016 July 2016 Medicaid Mental Health for Adults
12.17.2015 January 2016 Medicaid Mental Health for Adults Rev. 12.24.2015
07.2015 July 2015 Medicaid Mental Health for Adults
07.2014 July 2014 Medicaid Mental Health  for Adults
07.2013 July 2013 Medicaid Mental Health for Adults
01.2013 January 2013 Medicaid Mental Health for Adults
08.2012 July 2012 Medicaid Mental Health for Adults
08.2010 August 2010 Medicaid Mental Health for Adults
07.2008 July 2008 Medicaid Mental Health for Adults
10.2007 October 2007 Medicaid Mental Health for Adults
11.2006 November 2006 Medicaid Mental Health for Adults
07.2006 July 2006 Medicaid Mental Health for Adults
07.2004 July 2004 Medicaid Mental Health for Adults
07.2003 July 2003 Medicaid Mental Health for Adults

Youth Under 18

PDF
01/04/2017 January 2017 Medicaid Mental Health for Youth
11/22/2016 Integrated Co-Occurring Treatment Fees
06.08.2016 July 2016 Medicaid Mental Health for Youth
09.28.2015 October 2015 Medicaid Mental Health for Youth
07.2015 July 2015 Medicaid Mental Health for Youth
01.2015 January 2015 Medicaid Mental Health  for Youth
07.2014 July 2014 Medicaid Mental Health for Youth
03.2014 January 2014 Medicaid Mental Health for Youth
07.2013 July 2013 Medicaid Mental Health for Youth
08.2012 July 2012 Medicaid Mental Health  for Youth
09.2011 September 2011 Medicaid Mental Health for Youth
01.2011 January 2011 Medicaid Mental Health for Youth
08.2010 July 2010 Medicaid Mental Health for Youth

 

 

 

 

 

 

 

 

Fee Schedules – Mental Health Services Plan (MHSP)

Provider Notices 2010–

2017

04/06/2017 New EPSDT Request Form
02/17/2017 Targeted Mental Health Case Management and Representative Payee
Services

01/03/2017 New Guidelines for Outpatient Psychotherapy

2016

12/15/2016 Billing and Code Clarification for Psychotherapy and Psychiatric Diagnostic Services
11/01/2016 ICD 10 Updates and Coding Changes Revised 12/07/2016

10.20.2016

Clarification of Home Support Services
Admission Criteria – Outpatient Therapy

08.12.2016 Vaccine Administration by Pharmacists
08.12.2016 Removal of 15-day Supply Limit on Initial Atypical Antipsychotic Prescriptions
07.18.2016 Changes to Member Cost Share Update
05.19.2016 Changes to Member Cost Share
04.22.2016 Equine Assisted Therapy
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
12.30.2015 Addictive and Mental Disorders Division Changes to Prior Authorization
11.03.2015 Services Exempt from Passport to Health Referral
11.02.2015 CSCT Claims Issues Related to Updated Severe Emotional Disturbance (SED) Definition
10.01.2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
08.10.2015 Requesting Additional Therapy Sessions and Exception to 24 Sessions Request Form
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
01.30.2015 Billing Clarification Regarding Adjustments Made for 365-Day Lifetime Unit Limit for Home Support Services

2014

12.18.2014 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Final Notice
12.10.2014 Home Support Services and Therapeutic Group Home Utilization Review Update Notification
12.01.2014 Billing and Code Clarification for Individual and Family Therapy on the Same Day
09.17.2014 Montana Child and Adolescent Needs and Strengths (CANS)
09.16.2014 Adoption of the New Children's Mental Health Bureau's Medicaid Provider Manual into Administrative Rules of Montana
09.01.2014 Home Support Services and Therapeutic Group Home Utilization Review Process Changes Notification
08.13.2014 Community-Based Psychiatric Rehabilitation and Support (CBPRS) Clarification
08.13.2014 Montana Child and Adolescent Needs and Strengths (CANS)
08.05.2014 Montana Prescription Drug Registry
07.30.2014 Modifiers Added to Community Based Psychiatric Rehabilitation and Supports (CBPRS) Updated 08.13.2014
06.12.2014 ICD-10 Delay
05.13.2014 PERM Provider Educational Webinars
05.05.2014 CSCT Requirement
05.02.2014 Home Support Services Notification
04.22.2014 Modifier Changes for Professional Claim Billers
03.18.2014 Information Regarding CMS-1500
02.06.2014 Interactive Audio and Video Mental Health Services for Licensed Psychologists, LCPCs, and LCSWs
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
11.26.2013 ICD-10 Readiness
09.27.2013 Changes to Prior Authorization Requirements for Therapeutic Youth Group Homes – Additional Information
09.24.2013 Changes to Contract with Magellan Medicaid Administration (MMA)
09.11.2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes\
09.03.2013 Changes to Contract with Magellan Medicaid Administration (MMA)
08.15.2013 New Comprehensive School and Community Treatment (CSCT) Requirement
08.06.2013 Home Support Services Billing Clarification
07.10.2013 Psychiatrist Service Reimbursement Change and Timely Billing Requirement
07.08.2013 Montana Medicaid DSM-5 Implementation
06.28.2013 PRTF Montana-CANS Implementation
05.31.2013 Children's Mental Health Services Plan (CMHSP) Rules Repealed
05.28.2013 DPHHS to Discontinue Temporary Hotline Number
02.25.2013 Non-Medicaid Respite Services for Youth with Severe Emotional Disturbance (SED)
02.19.2013 Montana Medicaid HIPAA Operating Rules Upgrade
02.11.2013 Passport and Medical Evaluation with Psychotherapy Services

2012

12.26.2012 Medicaid/HMK Plus Toll-Free Number
10.31.2012 Eligibility for Children’s Mental Health Bureau Non-Medicaid Respite Care
10.22.2012 Mental Health Center Severe Disabling Mental Illness (SDMI) Clinical Assessment is a Covered Ancillary Service for Youth in a PRTF
10.01.2012 Documenting Medical Necessity for Therapeutic Family Care (TFC) and Therapeutic Foster Care (TFoC)
10.01.2012 Concurrent Outpatient Mental Health Therapy Services Reimbursed by Children’s Medicaid
09.26.2012 Changes to the Children's Mental Health Bureau's Provider Manual and Clinical Guidelines for Utilization Management and Authorization Request Forms
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 January 1, 2012
09.07.2011 Payment Error Rate Measurement (PERM)
08.16.2011 Care Coordination Is Available on a Limited Basis for Youth in a Psychiatric Residential Treatment Facility
07.18.2011 Reimbursement Changes for Covered Ancillary Services Provided to Youth in a PRTF and Additional Ancillary Services Are Covered
07.18.2011 Prior Authorization Requirements Discontinued for Targeted Case Management (TCM) and Outpatient Therapy Concurrent with Comprehensive School Community Treatment (CSCT)
06.27.2011 HIPAA 5010.OCR Qualifier Changes Effective January 1, 2012
06.24.2011 PRTF Waiver Site Denial Required
04.12.2011 Request: Claims Submission, Date of Payment by June 30, 2011
03.23.2011 Changes to Procedure Code Indicators
02.07.2011 Vaccine Administration Code Update

2010

11.17.2010 17-AHP
11.17.2010 Compound Drugs Billed on a CMS-1500
10.05.2010 Changes to NCCI Edits
09.15.2010 Unlinking Passport Providers No Longer Part of Group Practice
07.28.2010 Provider Record Update Procedures
07.15.2010 Vaccine Update Effective February 23, 2010
07.04.2010 Fee Schedule for Mirena
06.23.2010 Cost Sharing Exemption under ARRA
06.23.2010 Changes to the First Health Services Provider Manuals, Clinical Guidelines and Forms Used for Utilization Management of Children's Mental Health Medicaid Services
06.23.2010 Resource-Based Relative Value Scale (RBRVS) Information
06.22.2010 Electronic Health Records Link
06.04.2010 Medicaid Consultation Services
05.28.2010 Clinical Laboratory Fee Schedule (CLFS) Instructions for Test Codes 80100, 80101, 80101 QW, G0430, G0430 QW, and G0431 QW
05.25.2010 Medicaid Incentive Payment Program for Adopting Electronic Health Records
03.29.2010 Implantable Neurostimulators
02.09.2010 United States 2010 Census
02.08.2010 Medicaid Health Improvement Program
02.03.2010 Medicaid Consultation Services
01.21.2010 Reimbursement Change for Psychiatric Residential Treatment Facilities and How It Affects Other Montana Medicaid Providers

Provider Notices 2001–2009

2009

12.17.2009 Clarification of Prior Authorization Policy and Procedure

12.10.2009 Billing and Code Clarification for Psychological Testing and Request to Adjust Claims by December 31, 2009

10.01.2009 Healthy Montana Kids Plan

04.09.2009 Second Document of Frequently Asked Questions About Targeted Case Management (TCM) in Psychiatric Residential Treatment Facilities (PRTFs)

03.16.2009 Timely Filing for Medicare Crossovers

03.05.2009 Vagus Nerve Stimulation (VNS) 03.10.2009

02.26.2009 ATP Lab Fees 03.12.2009

02.25.2009 Vaccines for Children (VFC) Effective as of October 10, 2008

02.12.2009 Reimbursement Change for Psychiatric Residential Treatment Facilities and How It Affects Other Montana Medicaid Providers

2008

10.20.2008 Changes in Transplant Coverage 10.27.2008

08.12.2008 Federal Government May Request Medical Records 09.18.2008

07.11.2008 Changes in Mental Health Services Plan for Adults Age 18 and Older

05.29.2008 When to Submit an NDC (National Drug Code) If You Are Billing as a 340B Provider

05.22.2008 Frequently Asked Questions About NPI Reenrollment and Billing 06.17.2008

03.17.2008 Resubmission of Denied Claims 03.19.2008

03.10.2008 NPI Reenrollment and Billing

01.29.2008 Enhanced Claims Editing—Medicare Correct Coding Initiative Edits (CCI)

01.23.2008 Mental Health Fee Schedules and Billing

01.18.2008 Possible Duplicate Claims Processed Through Electronic Data Interchange

01.11.2008 Vaccines for Children (VFC)

2007

12.17.2007 Enhanced Claims Editing – Assistant . Team . Co-Surgeon

12.17.2007 Enhanced Claims Editing – Multiple Evaluation and Management Services Provided on the Same Day

12.03.2007 NPI Requirement for Fee-for-Service Healthcare Provider Claims

11.27.2007 Cost Share Changes

11.01.2007 Enhanced Claims Editing – Add-On Codes

11.01.2007 Enhanced Claims Editing – New Visit Evaluation and Management Codes

11.01.2007 Enhanced Claims Editing Bloodhound ClaimsGuard®

08.01.2007 Elimination of eSOR

06.25.2007 NPI on the Web Portal

06.11.2007 Ownership and Control Information Required for Reenrollment

06.06.2007 NPI Contingency Plan Implemented, Reenrollment Extended

05.31.2007 New CMS-1500 to Be Required Beginning July 2, 2007

01.26.2007 Mental Health Claims May Have Been Underpaid

2001–2006

03.20.2006 15-Day Supply Limit Clinical Edit on Initial Atypical Antipsychotic Prescriptions

07.28.2005 Scales – Congestive Heart Failure

02.04.2005 Introduction to Preferred Drug List

10.01.2004 Emergency Department Claims Appeal Process

06.10.2004 Team Care Program A New Component of the Passport to Health Program

01.22.2004 Lab and Radiology Services Covered Under MHSP Plan

02.23.2003 Chemical Dependency Procedure Code Changes

08.29.2003 Passport to Health Implementation in Prairie County

08.29.2003 DMEPOS Advisory Workgroup Openings

08.20.2003 Submitting HIPAA Compliant Claims – Information for All Providers

07.25.2003 MHSP Pharmacy Changes

07.01.2003 Mental Health Program Changes and Fees

01.29.2003 Prescription Drug Update

01.10.2003 New Provider Notification Procedure and Medicaid Changes

01.02.2003 Drug Prior Authorization Changes

10.01.2002 Billing for Medicare Crossovers After Medicare's 45-Day Response Time

02.14.2002 Weekly Payment Available

02.23.2001 MHSP Coverage for Children

01.26.2001 New Definitions for SED and SDMI

Forms

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.

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.