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Independent Diagnostic Testing Facilities (IDTF)

IDTF

Independent Diagnostic Testing Facility

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Physician-Related Services 11/2016

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: Medicaid Covered Services and Client Eligibility
04.29.2005 Member Number a Billable Number and Key Contacts Updated
11.05.2004 References to Medicaid Rules/Regulations Added
09.16.2004 Team Care and Nurse First Information Added

 

Physician-Related Services

11/28/2016 In summary, the Page 5.6 of the Billing Procedures chapter was amended to add information for locum tenens, several links were updated, and two blank pages were removed. The Table of Contents and Index sections were adjusted, several links were updated in the Introduction and Covered Services Chapter, the entire manual was formatted as approved by the September 2016 Manuals Meeting for initial 508 adaptations, and the Cover page was amended with the current date.

09/12/2016 In summary, the entire manual has undergone formatting changes, the Billing Procedures section has had some minor language changes and the Cover reflects the current date.

08.31.2016 In summary, The cost share section was removed from the Billing Procedures Chapter, related entries were removed from the Index Section adjustments were made to the Index Section , and the date was changed on the Cover Page.

07.31.2015 Physician-Related Services: Entire Manual

07.08.2014 Multiple Chapters

07.25.2006 Well-Child EPSDT Update

07.14.2006 Key Contacts, Completing a Claim Form, Prior Authorization, Billing for Immunizations

04.25.2006 Revised Instructions for Completing a Claim, Revised Information on How Cost-Sharing Affects Claim Payment

01.05.2006 New EPSDT, Hysterectomy Acknowledgement Form, Revised Information on Imaging Modifiers, Billing for Immunizations, and ER Visits for Clients under Age 2

03.01.2005 Hysterectomy Acknowledgement Update

01.25.2005 Rule References Added, Updates to Covered Services, PA and Modifiers

11.16.2004 Updated Prescription Drug PA Criteria

09.15.2004 Team Care Added

06.16.2004 Clarification on Sterilizations, Hysterectomies, Abortions and HIPAA and Drug PA Update

12.23.2003 Immunizations, PA Criteria, Family Planning, and Using Modifiers

09.16.2003 Hysterectomies and Prescription Drug PA Update

08/20.2003 New Emergency Services Policy and Hard Card Information

07.28.2003 Hysterectomy Requirements

06.01.2003 New PA Requirements and Hysterectomy Information

01.02.2003 Prior Authorization

09.01.2002 Cost Sharing

Medicaid Rules and Regulations

Fee Schedules – Independent Diagnostic Testing Facility (IDTF)

PDF Excel
01/09/2017 January 2017 IDTF 01/09/2017 January 2017 IDTF
07.2016 July 2016 IDTF Rev. 07.13.2016 07.2016 July 2016 IDTF Rev. 07.13.2016
01.18.2016 January 2016 IDTF Rev. 02.09.2016 01.18.2016 January 2016 IDTF Rev. 02.09.2016
07.2015 July 2015 IDTF 07.2015 July 2015 IDFT
01.2015 January 2015 IDTF 01.2015 January 2015 IDTF
07.2014 July 2014 IDTF 07.2014 July 2014 IDTF
02.2014 January 2014 IDTF 02.2014 January 2014 IDTF
12.2013 December 2013 IDTF 12.2013 December 2013 IDTF
07.2013 July 2013 IDTF 07.2013 July 2013 IDTF
01.2013 January 2013 IDTF 01.2013 January 2013 IDTF
07.2012 July 2012 IDTF FY 2013 07.2012 July 2012 IDTF FY 2013
01.2012 January 2012 IDTF 01.2012 January 2012 IDTF
09.2011 September 2011 IDTF 11.2011 09.2011 September 2011 IDTF 11.2011
02.2011 January 2011 IDTF 02.2011 January 2011 IDTF
07.2010 July 2010 IDTF 07.2010 July 2010 IDTF
02.2010 January 2010 IDTF 02.2010 January 2010 IDTF
07.2009 July 2009 IDTF 07.2009 July 2009 IDTF
01.2009 January 2009 IDTF 01.2009 January 2009 IDTF
07.2008 July 2008 IDTF 07.2008 July 2008 IDTF
01.2008 January 2008 IDTF 01.2008 January 2008 IDTF
10.2007 October 2007 IDTF 10.2007 October 2007 IDTF
01.2007 January 2007 IDTF 01.2007 January 2007 IDTF
07.2006 July 2006 IDTF 07.2006 July 2006 IDTF
01.2006 January 2006 IDTF 01.2006 January 2006 IDTF
07.2005 July 2005 IDTF 07.2005 July 2005 IDTF
01.2005 January 2005 IDTF 01.2005 January 2005 IDTF
07.2004 July 2004 IDTF 07.2004 July 2004 IDTF
01.2004 January 2004 IDTF 01.2004 January 2004 IDTF
01.2003 January 2003 IDTF 01.2003 January 2003 IDTF
07.2002 July 2002 IDTF (File corrupt) 07.2002 July 2002 IDTF (File corrupt)

Fee Schedules – ATP Tests and Fees

PDF
01/17/2017 January 2017 ATP
12.24.2015 January 2016 ATP
01.2015 January 2015 ATP
01.2014 January 2014 ATP
02.2013 January 2013 ATP
01.2012 January 2012 ATP
01.2011 January 2011 ATP
02.2010 January 2010 ATP
02.2009 January 2009 ATP
01.2007 January 2007 ATP
01.2006 January 2006 ATP 04.2006
03.2004 January 2004 ATP 01.2005

Provider Notices 2010–

2017
03/16/2017  Physician Administered Drugs - Update

2016

09/27/2016 Physician Administered Drugs - NDC Requirements Revised
07.18.2016 Changes to Member Cost Share Update
05.19.2016 Changes to Member Cost Share
02.10.2016 IDTF Fee Schedule Update
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
06.09.2015 National Drug Code (NDC) Billing
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
11.26.2013 ICD-10 Readiness
11.07.2013 Medicaid Passport to Health Referrals and Fee Schedules
11.07.2013 Radiology Procedures and Medicaid Passport to Health Referrals
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
11.04.2011 Meeting the Requirements of HIPAA 5010 When Reporting National Drug Codes on Electronic 837I and 837P Transactions 11.16.2011
09.09.2011 HIPAA 5010.OCR Qualifier Changes Effective January 1, 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
06.23.2010 Resource-Based Relative Value Scale (RBRVS) Information
06.22.2010 Electronic Health Records Link
02.09.2010 United States 2010 Census

Provider Notices 2002–2009

2009

2008

2007

2001–2006

Other Resources

EOB R&R Crosswalk and EOB R&R Crosswalk 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.

Lab Panels 2007 01.2007
List of codes that make up lab panels for 2004–2007

Prior Authorization Criteria for Specific Services

Rebateable Manufacturers 01/2017

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.