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Department of Public Health and Human Services

Montana Healthcare Programs Provider Information » Nursing Facility

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Nursing Facility

Nursing Facility

Provider Manuals

General Information for Providers  

Medicaid manual with general information for all provider type

Nursing Facility and Swing Bed Services 10/2017

This manual has information specific to your provider type.

Medicaid Rules and Regulations

Fee Schedules – Ancillary Services

January 2014

PDF: January 2014 Ancillary Services Rev. 06/27/2017  Cover Sheet: January 2014 Ancillary Services Rev. 06/27/2017
Excel: January 2014 Ancillary Services Rev. 06/27/2017
TXT: January 2014 Ancillary Services Rev. 06/27/2017

Fee Schedules - Nursing Facility Medicaid Rates

Fee Schedules - Nursing Facility Private Pay Rates

Provider Notices

2020

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


04/07/2020 Requirements and Billing for Telehealth Services by Nursing Facilities
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

01/10/2020 Co-Payment Assessed in Error for January 6, 2020 Payment

2019

12/27/2019 Elimination of Copayments
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

11/20/2018 Appropriate Billing Reminder
11/08/2018 Rate Updates Mass Adjustment
10/19/2018 Medicaid Fee Schedules
07/11/2018 Nursing Facility Claim Billers - Rates Effective 07/01/2018
07/02/2018 Updated CLIA Claims Editing
06/13/2018 Nursing Facility Claim Billers - Rates Effective 06/13/2018 REVISED 06/21/2018
06/04/2018 Coding Resources Change
04/04/2018  Updated Passport Eligible Populations & Reimbursement
03/14/2018 Prior Authorization for Genetics Testing for Youth Mental Health
02/26/2018 New Rendering Only Provider Enrollment Application

Nursing Home Staffing Report

Nursing Facilities Forms

Nursing Facilities Forms

Medicaid Cost Report Instructions
Monthly Staffing Report
Therapeutic Home Visit
Therapeutic Home Visit 72 Hours
Hospital Hold
 

Additional forms for all provider types are found on the Forms Page.

Level of Care Screens (LOC) for Nursing Facility Residents

Level of Care Screens (LOC) for Nursing Facility Residents
Level of care screening must be completed for Medicaid patients in order to receive Medicaid payments for nursing facility stays.  The level of care screening must be requested prior to admission or Medicaid coverage as they may only be backdated 30 days if the individual meets level of care and has completed a Level I screen. Please review the information below regarding level of care.

Please review the following:

LOC Level of Care Screening Information
LOC Cover letter
LOC Flow Chart
LOC Determination form
If you have any questions about LOC(s), please contact Mountain Pacific Quality Health at 443-0320 or 1-800-219-7035. Questions regarding this correspondence can be directed to either Shaunda Hildebrand at (406) 444-4209 or Jill Sark at (406) 444-4544.

MDS 3.0

What is MDS 3.0?
Changes to the federal minimum data set (MDS) tool (Version 3.0 assessment), went into effect on October 1, 2010.  One of these changes relates to Nursing Facilities (SNFs/NFs), States, and other qualified entities to identify individuals that are interested in returning to the community.

Frequently Asked Questions
Letter to Nursing Facilities
Community Alternatives
Your Discharge Planning Check List

Civil Money Penalties Program (CMP)

Civil Money Penalties Program (CMP)
A civil money penalty (CMP) is a monetary penalty the Centers for Medicare & Medicaid Services (CMS) may impose against skilled nursing facilities (SNF’s), nursing facilities (NF’s), and dually-certified SNF/NF for either the number of days or for each instance a facility is not in substantial compliance with one or more Medicare and Medicaid participation requirements for Long Term Care Facilities. A portion of CMP’s collected from facilities are returned to the States in which the CMP’s are imposed to provide grant funding to benefit nursing facility residents.

Civil Money Penalty Reinvestment )(CMP) Application Template COVID-19 for In-Person Visitation Aids Request

COVID-19 Communication Technology CMP Grant Information
Civil Money Penalty (CMP) Reinvestment Application Template

Civil Money Penalties (CMP) Information rev. 10/01/2020
Application for Use of Civil Money Penalty Funds

CMS CMP Toolkits and other helpful resources
Civil Monetary Penalties (CMP) Awardees

Local Contact Agencies

Long Term Care Ombudsman

Other Resources

To locate older documents, access the Archive Page.