EPSDT / Children’s Services

Early and Periodic Screening, Diagnostic, and Treatment Services

Prior Authorization Forms Claim Jumper Newsletters

General Information for Providers  

Medicaid manual with general information for all provider types.

This manual has information specific to your provider type.

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.

2021

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

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

04/22/2020  Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs


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

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