Welcome to the Montana Healthcare Programs
Provider Information Website.



American Rescue Plan Act of 2021

Revised October 4, 2021
This announcement was originally posted August 20, 2021.

Montana Home and Community Services Spending Narrative and Plan Submitted September 28, 2021.

The American Rescue Plan Act of 2021 (ARPA) provides a unique opportunity to improve home and community-based service (HCBS) provision for Montanan’s enrolled in the Montana Medicaid program.

Section 9817 of the ARPA provides states with a one year 10-percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures that meet the ARPA definition of HCBS.

States are then able to invest the saved state funding in eligible activities that enhance, expand, or strengthen HCBS under the Medicaid program. The investment of saved state dollars can further be matched with federal Medicaid funds dramatically increasing the impact for HCBS recipients and providers.

For more information regarding the American Rescue Plan Act of 2021 and the CMS response to the original submission, please refer to:

MT Conditional Approval 9817 ARP
ARPA Home and Community Services Spending Plan and Narrative

Applied Behavior Analysis (ABA) Services State Plan Amendment

July 29, 2021

The Applied Behavior Analysis Services State Plan Amendment, which includes Autism services, will be submitted to CMS for review by September 30, 2021. While the State Plan Amendment is under review, Montana Medicaid will not process claims for the proposed expanded CPT codes and services. The public notice detailing the proposed changes to the Preventive Services Autism Treatment Services State Plan can be found on the ABA webpage https://dphhs.mt.gov/assets/hrd/PublicNotices/AppliedBehavioralAnalysisMedicadStatePlanAmendmentPosted07132021.pdf

Approved CPT service codes will be billable retroactive to August 1, 2021. Claims can be billed for up to 365 days after the service is provided. If you have questions regarding this change, please contact Barbara Doggett at Barbara.Doggett@mt.gov or by telephone at (406) 444-3878.

This announcement will be sent to the Board Certified Behavior Analysis (BCBA) interested parties lists from the Developmental Disabilities Program. Updates to this announcement will be made as information becomes available.


Montana Uninsured COVID-19 Testing and Treatment Program Expiration

On June 30, 2021, Governor Gianforte issued Executive Order Number 10-2021. This Executive Order rescinds Executive Order Number 2-2021 and lifts the Montana state of emergency.

Effective July 1, 2021, this declaration ends the Montana Uninsured COVID-19 Testing and Treatment Program. While the program has ended, claims with a date of service on or before June 30, 2021, may continue to be submitted for reimbursement.

Providers are encouraged to utilize the Health Resources and Services Administration Uninsured COVID-19 Testing, Treatment, and Vaccine Administration Program. Additional information for this program can be found at https://www.hrsa.gov/CovidUninsuredClaim.

For additional provider information, please see the provider notice "Adoption Of Temporary Emergency Rule To Allow for COVID-19-Related
Regulatory Discretion Beyond The Expiration Of The Governor-Declared State Of Emergency"


Additional Fax Number for Provider Relations Now Available

Provider Relations has added a second fax number, 888-772-2341. If the primary number is busy, please use the new fax number. Both lines can be used for faxed requests for Provider Relations.(Posted 03/12/2020).


Elimination of Copayments

Effective January 1, 2020, all claims paid will no longer post a copayment amount. For specifics, please refer to the Elimination of Copayment Provider Notice and the Copayment Elimination FAQs.


Information Reminder

Providers are able to access information 24/7 by calling Provider Relations at(800)624-3958.

When the system answers, Providers choose Option 7. Option 1 is for pharmacies requesting unlock and Option 5 is for members.

On the next menu, select one of the following options:


We appreciate the work you do at all hours of the day and night to serve Montana Healthcare Program members. The IVR is there to help you get the information you need when you need it. (posted 08/16/2019)


Online Training Available

SURS Training
Presented by Jennifer Tucker, SURS Supervisor, DPHHS, October 21, 2021 at 1:30pm Mountain Time (1 hour)
Jessica Coe, Hospitals Program Officer, DPHHS, November 18, 2021 at 2pm Mountain Time (1 hour)
Vision Services 
Laurie Nelson, Optometrics Program Officer, DPHHS, December 16, 2021 at 2pm Mountain Time (1 hour)

To register for upcoming Online Training and access to previous Training PowerPoints, please visit the Training page at https://medicaidprovider.mt.gov/training.