Ambulatory Surgical Center
General Information for Providers
Medicaid manual with general information for all provider types.
Ambulatory Surgical Center Services
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
April 2025 ASC Coversheet
April 2025 ASC Fee Schedule PDF
April 2025 ASC Fee Schedule Excel
January 2025 ASC Cover Sheet
January 2025 ASC Fee Schedule PDF
January 2025 ASC Fee Schedule Excel
October 2024 ASC Cover Sheet
October 2024 ASC Fee Schedule PDF
October 2024 ASC Fee Schedule Excel
July 2024 ASC Cover Sheet
July 2024 ASC Fee Schedule PDF
July 2024 ASC Fee Schedule Excel
April 2024 ASC Cover Sheet
April 2024 ASC Fee Schedule PDF Revised 07/01/2024
April 2024 ASC Fee Schedule Excel Revised 07/01/2024
January 2024 ASC Cover Sheet
January 2024 ASC Fee Schedule PDF
January 2024 ASC Fee Schedule Excel
October 2023 ASC Cover Sheet
October 2023 ASC Fee Schedule PDF
October 2023 ASC Fee Schedule Excel
July 2023 ASC Cover Sheet
July 2023 ASC Fee Schedule PDF
July 2023 ASC Fee Schedule Excel
April 2023 ASC Coversheet
April 2023 ASC Fee Schedule PDF
April 2023 ASC Fee Schedule Excel
January 2023 ASC Coversheet
January 2023 ASC Fee Schedule PDF Revised 02/24/2023
January 2023 ASC Fee Schedule Excel Revised 02/24/2023
October 2022 ASC Coversheet
October 2022 ASC Fee Schedule PDF Revised 02/24/2023
October 2022 ASC Fee Schedule Excel Revised 02/24/2023
July 2022 ASC Cover Sheet
July 2022 ASC Fee Schedule PDF Revised 02/24/2023
July 2022 ASC Fee Schedule Excel Revised 02/24/2023
April 2022 ASC Coversheet
April 2022 ASC Fee Schedule PDF Rev. 02/24/2023
April 2022 ASC Fee Schedule Excel Rev. 02/24/2023
January 2022 ASC Coversheet
January 2022 ASC Fee Schedule PDF Rev. 02/24/2023
January 2022 ASC Fee Schedule Excel Rev. 02/24/2023
October 2021 ASC Coversheet
October 2021 ASC Fee Schedule PDF
October 2021 ASC Fee Schedule Excel
July 2021 ASC Cover Sheet
July 2021 ASC Fee Schedule PDF
July 2021 ASC Fee Schedule Excel
April 2021 ASC Coversheet
April 2021 ASC Fee Schedule PDF rev. 04/26/2021
April 2021 ASC Fee Schedule Excel rev. 04/26/2021
January 2021 ASC Coversheet
January 2021 ASC Fee Schedule PDF rev. 07/20/2021
January 2021 ASC Fee Schedule Excel rev. 07/20/2021
October 2020 ASC Coversheet
October 2020 ASC Fee Schedule PDF
October 2020 ASC Fee Schedule Excel
January 2020 ASC Coversheet
January 2020 ASC Fee Schedule PDF
January 2020 ASC Fee Schedule Excel
2025
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
2024
12/19/2024 IRS Tax Identification Letter Required for Pay-To Providers
11/04/2024 Paper Claim Denials
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
06/28/2024 January 1, 2024 and July 1, 2024 Fee Schedule Updates
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
05/01/2024 Paperwork Attachments Submission Timing for Electronic Claims
05/01/2024 Eligibility Inquiry and Service Type Code in the MATH Portal
04/19/2024 Changes Regarding Opioid Prior Authorization and Medication for Opioid Use Disorder
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 Medicaid 12-Month Postpartum Continuous Eligibility Coverage
01/23/2024 Montana Healthcare Programs Support Services Holiday Closure REVISED
01/08/2024 Electronic Claim Adjustment Processing Change
2023
12/22/2023 Passport Provider Referral Number on Claims
12/12/2023 Individual Providers Enrolled as Sole Proprietors Due for Revalidation
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
09/06/2023 Provider Rate Increases Systematic Adjustments
08/01/2023 Provider License Expiration Reminder Letters
07/06/2023 Provider Rate Increases
05/26/2023 Medicaid Reimbursement and Court Ordered Services REVISED
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
01/04/2023 Montana Healthcare Programs Support Services Holiday Closures
2022
12/23/2022 Plan First Updated Code List Descriptions
09/19/2022 New Plan First Covered Code
09/01/2022 Sterilization Consent Form MA-38 to be Discontinued
08/05/2022 Bipartisan Budget Act of 2018 Cost Avoidance Statute Changes
06/17/2022 Plan First Updated Code List Descriptions
06/03/2022 Circumcision Prior Authorization Changes REISSUED
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
2021
12/20/2021 Plan First Updated Code List Descriptions
12/15/2021 Health Behavior Assessment and Intervention Billing Codes Rev. 04/26/2022
12/10/2021 New Provider Services Portal
09/24/2021 Codes Removed from and Added to Plan First Covered Code List
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
05/21/2021 Sterilization Consent Form MA-38 to be Discontinued
04/02/2021 New Provider Type – Licensed Marriage and Family Therapist
01/28/2021 Montana Healthcare Programs Support Services Holiday Closures
01/21/2021 Montana Plan First Additional Codes Added to Plan First Covered Code List
01/11/2021 Provider Support Services Closed for Martin Luther King Day, Monday, January 18, 2021
2020
12/07/2020 Medicaid Expansion Extended Through December 31, 2021
12/01/2020 Change in Application Process for Plan First
11/12/2020 Removal of Codes for COVID-19 Testing and Treatment
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
07/27/2020 Montana Plan First - Additional Covered Code, COVID - Testing
07/24/2020 Provider Relief Fund General Allocation
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
04/23/2020 Elimination of Prior Authorization and Criteria Requirements for MRI of the Head and CT of the Brain
04/01/2020 Suspension of Face to Face Requirements for Some Medicaid Programs
03/26/2020 Montana Plan First - Additional Covered Codes, Telemedicine/Telehealth
03/19/2020 Telemedicine Medicaid Coverage and Reimbursement Policy for Telemedicine/Telehealth rev 03/27/2020