General Information for Providers
Medicaid manual with general information for all provider types.
Nutrition EPSDT
This manual has information specific to your provider type.
Orientation and Mobility Specialist
This manual has information specific to your provider type.
Physician-Related Services
This manual has information specific to your provider type.
Private Duty Nursing EPSDT
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 2022 Nutrition EPSDT Coversheet
July 2022 Nutrition EPSDT Fee Schedule PDF
July 2022 Nutrition EPSDT Fee Schedule Excel
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 2022 Orientation and Mobility Coversheet
July 2022 Orientation and Mobility Fee Schedule PDF
July 2022 Orientation and Mobility Fee Schedule 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 2022 Private Duty Nursing Coversheet
July 2022 Private Duty Nursing Fee Schedule PDF
July 2022 Private Duty Nursing Fee Schedule 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
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
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
01/04/2023 Montana Healthcare Programs Support Services Holiday Closures
08/05/2022 Bipartisan Budget Act of 2018 Cost Avoidance Statute Changes
05/16/2022 Help Members Receive Important Information from Montana Medicaid and Stay Covered
05/13/2022 Revalidation Extended REVISED
05/13/2022 National Drug Code (NDC) Denial Errors
04/26/2022 Health Behavior Assessment and Intervention Billing Codes REVISED
03/29/2022 Nurse First Advice Line Services Ending
03/16/2022 Revalidation Extended to June 2022 REVISED Rev. 05/13/2022
02/23/2022 Revalidation Extended to June 2022 Rev. 03/16/2022
02/23/2022 Standing Orders and Medicaid Reimbursement
01/14/2022 Montana Healthcare Programs Support Services Holiday Closures
01/03/2022 Non-Therapeutic CGM Devices
12/15/2021 Health Behavior Assessment and Intervention Billing Codes Rev. 04/26/2022
12/10/2021 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
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
08/11/2020 Provider Relief Fund General Allocation 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