Hospital Inpatient

Prior Authorization Forms Claim Jumper Newsletters

General Information for Providers
Medicaid manual with general information for all provider types.

Hospital Inpatient Services 
This manual has information specific to your provider type.

Critical Access Hospitals 
This manual has information specific to critical access hospitals.

2025

04/29/2025 Audio-Only Codes
04/23/2025 Written Orders Regarding Occupational, Physical, and Speech Therapy
03/31/2025 Payment To Be Suspended for Providers Without Current Financial Information
02/11/2025 EFT Authorization Agreement Updated
02/04/2025 Health Behavior Assessment and Intervention Billing Codes
01/15/2025 Montana Healthcare Programs Support Services Holiday Closures
01/06/2025 Montana Prescription Drug Registry Survey for Federal Fiscal Year 2024

2024

12/19/2024 IRS Tax Identification Letter Required for Pay-To Providers
12/06/2024 Coverage for Botox (onabotulinumtoxinA) REVISED
12/04/2024 Change in the Double Electric Breast Pump Provider
11/04/2024 Paper Claim Denials
10/30/2024 Beyfortus and Synagis Coverage for RSV Prophylaxis
10/18/2024 Electronic Adjustments Void or Void/Replace
10/15/2024 Revalidation Requirements Deadline
10/11/2024 COVID-19 Vaccine Codes Removed from Plan First Covered Codes List
07/29/2024 Prior Authorization Requirements When a Member Has Third Party Liability
06/28/2024 January 1, 2024 and July 1, 2024 Fee Schedule Updates
06/20/2024 Hospital Transfers: In State Versus Out of State
06/18/2024 DEA Number Required for Prescribers REVISED
06/11/2024 Health Resources Division Claims Appeal Process
05/21/2024 DEA Number Required for Prescribers
05/10/2024 Ordering Genetic Lab Tests from Assurex Health
05/01/2024 Paperwork Attachments Submission Timing for Electronic Claims
05/01/2024 Eligibility Inquiry and Service Type Code in the MATH Portal
04/30/2024 Diabetes Prevention Program Information
04/19/2024 Changes Regarding Opioid Prior Authorization and Medication for Opioid Use Disorder
04/08/2024 Negative Pressure Wound Therapy Pumps (E2402) Do Not Require Prior Authorization
04/05/2024 Written Orders for Physical, Occupational, and Speech Therapy
03/27/2024 HHS Letter to Healthcare Providers
03/27/2024 Resources for Providers in Response to the Change Healthcare Cyberattack
03/27/2024 Updated CLIA Claims Editing
03/27/2024 Avoiding Claim Denials
03/27/2024 Location Address and Provider Maintenance Updates
03/19/2024 Electronic Funds Transfer Payment Verification
03/12/2024 Valid Member ID and Eligibility Verification
03/12/2024 Provider Initiated Claims Adjustment
03/05/2024 Voiding Claims With a Prior Authorization
02/14/2024 How to Obtain a Double Electric Breast Pump, HCPCS E0603
02/14/2024 Medicaid 12-Month Postpartum Continuous Eligibility Coverage
02/08/2024 Hospital Facility Utilization Fee 2023
01/23/2024 Montana Healthcare Programs Support Services Holiday Closure REVISED
01/08/2024 AMP Cap Removal and Medication Access
01/08/2024 Electronic Claim Adjustment Processing Change 

2023

12/22/2023 Passport Provider Referral Number on Claims
12/19/2023 Montana Prescription Drug Registry Survey
12/12/2023 Individual Providers Enrolled as Sole Proprietors Due for Revalidation
11/20/2023 Fetal Chromosomal Aneuploidy Testing REVISED
11/08/2023 Prior Authorization Information
11/01/2023 Beyfortus and Synagis Coverage for RSV Prophylaxis
10/31/2023 Managed Care Referrals IHS, Tribal 638, and Urban Indian Organizations REVISED
09/15/2023 Claims Payment Discrepancy Update
09/14/2023 Claims Payment Discrepancy Identified
09/08/2023 Medicaid Claims Payment Delayed
08/30/2023 Attestation Form Required for Qualifying Clinical Trials
08/01/2023 Provider License Expiration Reminder Letters
07/06/2023 Provider Rate Increases
05/26/2023 Medicaid Reimbursement and Court Ordered Services REVISED
05/08/2023 Diabetes Prevention Program (DDP) Information REVISED
05/05/2023 Medicaid Coverage of Abortion Services REVISED
05/01/2023 Medicaid Coverage of Abortion Services
04/10/2023 Resumption of Face-to-Face Requirements for Selected Programs REVISED
03/22/2023 Coverage and Reimbursement Policy for Telemedicine/Telehealth Services
03/22/2023 End of Public Health Emergency (PHE) Effects on Pharmacy Coverage
03/22/2023 Non-Covered Services Agreement Policy Return to Requirements
03/22/2023 Reinstatement of the Primary Care Provider Referral for Passport
03/22/2023 Resumption of Face-to-Face Requirements for Selected Programs
03/22/2023 Resumption of Prior Authorization Requirements Revised 04/03/2023
03/17/2023 End of Temporary Revision to Case Management General Provisions
03/10/2023 Provider Meetings for Medicaid Eligibility Redetermination and Unwinding PHE Flexibilities
03/09/2023 Add-on and E&M Code Editing
03/03/2023 End of Public Health Emergency
02/10/2023 837I Ancillary Charge Claim Rejections
01/04/2023 Montana Healthcare Programs Support Services Holiday Closures