EPSDT / Children’s Services
Early and Periodic Screening, Diagnostic, and Treatment Services
General Information for Providers
Medicaid manual with general information for all provider types.
This manual has information specific to your provider type.
This manual has information specific to your provider type.
Orientation and Mobility Specialist
This manual has information specific to your provider type.
This manual has information specific to your provider type.
This manual has information specific to your provider type.
Code of Federal Regulations (Title 42)
Montana Code Annotated - https://leg.mt.gov/ (Choose “Laws & Bills” then “ Montana Statutes – MCA”)
Applicable Section: Title 53, Chapter 6
July 2019 Children's Special Health Services Coversheet
July 2019 Children's Special Health Services Fee Schedule PDF
July 2019 Children's Special Health Services Fee Schedule Excel
July 2018 Children's Special Health Services Coversheet
July 2018 Children's Special Health Services Fee Schedule PDF
July 2018 Children's Special Health Services Fee Schedule Excel
01/10/2018 January 2018 Children's Special Health Services Fee Schedule
July 2021 Nutrition EPSDT Coversheet
July 2021 Nutrition EPSDT Fee Schedule PDF
July 2021 Nutrition EPSDT Fee Schedule Excel
July 2020 Nutrition EPSDT Coversheet
July 2020 Nutrition EPSDT Fee Schedule PDF
July 2020 Nutrition EPSDT Fee Schedule Excel
July 2019 Nutrition EPSDT Coversheet
July 2019 Nutrition EPSDT Fee Schedule PDF
July 2019 Nutrition EPSDT Fee Schedule Excel
January 2019 Nutrition EPSDT Coversheet
January 2019 Nutrition EPSDT Fee Schedule PDF
January 2019 Nutrition Fee Schedule Excel
July 2018 Nutrition EPSDT Coversheet Version 2
July 2018 Nutrition EPSDT Fee Schedule Version 2 PDF
July 2018 Nutrition EPSDT Fee Schedule Version 2 Excel
July 2018 Nutrition EPSDT Coversheet
July 2018 Nutrition EPSDT Fee Schedule PDF
July 2018 Nutrition EPSDT Fee Schedule Excel
January 2018 Nutrition PDF
January 2018 Nutrition Excel
July 2021 Orientation and Mobility Coversheet
July 2021 Orientation and Mobility Fee Schedule PDF
July 2021 Orientation and Mobility Fee Schedule Excel
July 2020 Orientation and Mobility Coversheet
July 2020 Orientation and Mobility Fee Schedule PDF
July 2020 Orientation and Mobility Fee Schedule Excel
July 2018 Orientation and Mobility Coversheet Version 2
July 2018 Orientation and Mobility Fee Schedule Version 2 PDF
July 2018 Orientation and Mobility Fee Schedule Version 2 Excel
July 2018 Orientation and Mobility Coversheet
July 2018 Orientation and Mobility Fee Schedule PDF
July 2018 Orientation and Mobility Fee Schedule Excel
January 2018 Orientation and Mobility Cover Sheet
January 2018 Fee Schedule Orientation and Mobility PDF
January 2018 Fee Schedule Orientation and Mobility Excel
July 2021 Private Duty Nursing Coversheet
July 2021 Private Duty Nursing Fee Schedule PDF
July 2021 Private Duty Nursing Fee Schedule Excel
July 2020 Private Duty Nursing Coversheet
July 2020 Private Duty Nursing Fee Schedule PDF
July 2020 Private Duty Nursing Fee Schedule Excel
July 2019 Private Duty Nursing Coversheet
July 2019 Private Duty Nursing Fee Schedule PDF
July 2019 Private Duty Nursing Fee Schedule Excel
July 2018 Private Duty Nursing Coversheet
July 2018 Private Duty Nursing Fee Schedule in PDF
July 2018 Private Duty Nursing Fee Schedule in Excel
January 2018 Private Duty Nursing Cover Sheet
January 2018 Private Duty Nursing Fee Schedule
2022
01/14/2022 Montana Healthcare Programs Support Services Holiday Closures01/03/2022 Non-Therapeutic CGM Devices
2021
12/15/2021 Health Behavior Assessment and Intervention Billing Codes12/10/2021 New Provider Services Portal
11/02/2021 Therapeutic Continuous Glucose Monitor (CGM) Devices
09/16/2021 Billing Update - Licensed Marriage and Family Therapist (LMFT)
07/20/2021 Enrollment Update – Licensed Marriage and Family Therapist
07/06/2021 Adoption Of Temporary Emergency Rule To Allow for COVID-19-Related
Regulatory Discretion Beyond The Expiration Of The Governor-Declared State Of Emergency
06/11/2021 COVID-19 Vaccine Administration Billing Guidance
05/05/2021 Date Spans for Prior Authorization Through the Qualitrac Portal
04/02/2021 New Provider Type – Licensed Marriage and Family Therapist
03/01/2020 DME and DME EPSDT Prior Authorizations Through the Qualitrac Portal
01/28/2021 Montana Healthcare Programs Support Services Holiday Closures
01/11/2021 Provider Support Services Closed for Martin Luther King Day, Monday, January 18, 2021
2020
12/23/2020 Diabetes Prevention Program (DPP) Information
12/07/2020 Medicaid Expansion Extended Through December 31, 2021
11/17/2020 Prior Authorizations Through the Qualitrac Web Portal for DME and DME EPSDT
10/28/2020 Provider Relief Fund General Allocation
08/28/2020 Provider Relief Fund General Allocation rev. 08/28/2020
- Overview and Access Guide for Seeking Provider Relief Funding from HHS Allocation to Medicaid Providers rev. 08/28/2020
08/11/2020 Provider Relief Fund General Allocation rev. 08/11/2020
- Overview and Access Guide for Seeking Provider Relief Funding from HHS Allocation to Medicaid Providers rev. 08/11/2020
07/24/2020 Provider Relief Fund General Allocation
07/17/2020 Medicaid Reimbursement and Court Ordered Services
06/17/2020 National Correct Coding Initiative Announcement
05/15/2020 Temporary Revision to Case Management General Provisions
04/30/2020 National Correct Coding Initiative Announcement
04/28/2020 Temporary Suspension of the PCP Referral Requirement
04/27/2020 Non-Covered Services Agreement Policy Change
04/01/2020 Suspension of Face to Face Requirements for Some Medicaid Programs
03/19/2020 Telemedicine Medicaid Coverage and Reimbursement Policy for Telemedicine/Telehealth rev 03/27/2020
03/12/2020 Medical Food or Formula for Phenylketonuria (PKU) due to Inborn Errors of Metabolism (IEM) - HCPCS Code S9435
01/10/2020 Co-Payment Assessed in Error for January 6, 2020
2019
11/22/2019 New Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Review and
Process through Qualitrac Portal
11/18/2019 HCPCS Modifiers - XE, XS, and XU (Reissued Notice)
05/20/2019 Nurse Visit - Appropriate Billing Reminder - Revised Clarification rev. 05/30/2019
2018
03/20/2019 Prior Authorization Qualitrac Portal
11/20/2018 Appropriate Billing Reminder
11/13/2018 Diabetes Prevention Program (DPP) Claims Update
11/08/2018 Rate Updates Mass Adjustment
11/07/2018 Mass Adjustments
10/19/2018 Medicaid Fee Schedules
07/24/2018 Diabetes Prevention Program (DPP) Coding Change
07/02/2018 Updated CLIA Claims Editing
06/04/2018 Coding Resources Change
04/04/2018 Updated Passport Eligible Populations & Reimbursement
02/26/2018 New Rendering Only Provider Enrollment Application