Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Therapeutic Foster Care

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Therapeutic Foster Care

Therapeutic Foster Care

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Mental Health Services – Adult 01.2016

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, 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, October 2004: References to Medicaid Rules and Regulations Added
09.16.2004 General Information for Providers: Team Care and Nurse First Information Added

 

Medicaid Rules and Regulations

Fee Schedules – 72-Hour Presumptive

Fee Schedules – Medicaid Mental Health

Fee Schedules – Mental Health Services Plan (MHSP)

Provider Notices 2010–

2017

04/06/2017 New EPSDT Request Form
01/03/2017 New Guidelines for Outpatient Psychotherapy

2016

11/01/2016 ICD 10 Updates and Coding Changes Revised 12/07/2016
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
05.02.2014 Home Support Services Notification
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)
08.06.2013 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
02.19.2013 Montana Medicaid HIPAA Operating Rules Upgrade

2012

12.26.2012 Medicaid/HMK Plus Toll-Free Number
10.01.2012 Documenting Medical Necessity for Therapeutic Family Care (TFC) and Therapeutic Foster Care (TFoC)
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
01.20.2011 Procedure Code Changes to Current Prior Authorizations and Billing Instructions

2010

10.05.2010 Changes to NCCI Edits
07.28.2010 Provider Record Update Procedures
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
06.22.2010 Electronic Health Records Link
02.09.2010 United States 2010 Census
01.21.2010 Reimbursement Change for Psychiatric Residential Treatment Facilities and How It Affects Other Montana Medicaid Providers

Provider Notices 2001–2009

2009

2008

2007

2001–2005

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.