Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Hospital Inpatient

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Hospital Inpatient

Hospital Inpatient

Provider Manuals

General Information for Providers  05/2019
Medicaid manual with general information for all provider types.
Hospital Inpatient Services  06/2018
This manual has information specific to your provider type.
Critical Access Hospitals 06/2018
This manual has information specific to critical access hospitals.

Medicaid Rules and Regulations

Fee Schedules - Hospital - APR DRG

Provider Notices



11/20/2018 Appropriate Billing Reminder
11/08/2018 Rate Updates Mass Adjustment
11/06/2018 Smart PA® Prior Authorization for Synagis®
10/19/2018 Medicaid Fee Schedules
10/09/2018 CT of the Brain and MRI of the Head Tips
07/02/2018 Updated CLIA Claims Editing
06/12/2018 Approved Diagnosis Codes for Botox
06/04/2018 Coding Resources Change
05/30/2018 Panniculectomy Criteria
05/01/2018 Condition Code - LARC Immediately After Delivery
04/24/2018 Present on Admission (POA) Billing Update
04/24/2018 Out-Of_state Inpatient Admissions Prior Authorization
04/18/2018 New AMDD Medicaid Services Provider Manual for Substance Use Disorder and Adult Mental Health
04/04/2018  Updated Passport Eligible Populations & Reimbursement
02/26/2018 New Rendering Only Provider Enrollment Application
02/15/2018 Reimbursement Rate Change
01/31/2018 Montana Healthcare Programs Covered Double Electric Breast Pumps - E0603
01/30/2018 Fetal Chromosomal Aneuploidy Testing
01/22/2018 HCPCS code G0515 replaces 97532
01/12/2018 Infertility Treatment Code-J0725


12/29/2017 Prior Authorization for Transgender Mastectomy/Breast Augmentation
12/29/2017 Prior Authorization for Gender Reassignment Surgery
12/26/2017 MATH Web Portal Eligibility Inquiry Verification Update
12/26/2017 Inpatient Reimbursement Rate
12/26/2017 CAH Reimbursement Rate
12/18/2017 Fetal Chromosomal Aneuploidy Testing
12/11/2017  Montana Plan First Procedure and Service Codes - Contraceptive (IUD) Update
12/01/2017 Montana Medicaid Expansion Prior Authorization Changes
11/21/2017 Severe Disabling Mental Illness (SDMI) rev. 11/22/2017
11/20/2017 Qualified Medicare Beneficiary (QMB) Claim Adjustments
11/13/2017 Smart PA® Prior Authorization for Synagis®
11/02/2017 New Medicare Card
10/02/2017 Montana Medicaid Expansion Changes
09/14/2017 Montana Plan First Anesthesia Update
08/21/2017 Clinical Pharmacist Practitioner
08/01/2017 Telemedicine - Correction
05/26/2017 Federal Final Rule, "Nondiscrimination in Health Program and Activities” and Implication for Coverage of Services Related to Gender Transition
05/15/2017 OOS Adult Acute Mental Health Inpatient Hospital Prior Authorizations
05/01/2017 Vaccine Administration Code Update
04/24/2017 Unlisted Services or Procedures Reminder
04/20/2017 Plan First Hysterectomy codes added effective April 1, 2017
04/06/2017 New EPSDT Request Form
04/04/2017 PA Criteria for Artificial Disc Replacement
04/04/2017 Criteria for Orthognathic Surgery
04/04/2017 Changes to Medical Surgical PA
04/04/2017 Criteria for Panniculectomy
02/23/2017 Mass Adjustment to Correct the Base Rate Calculation
02/02/2017 EPSDT ( Children's) Lead Screening Requirements

Other Resources

To locate older documents, access the Archive Page.