General Information for Providers
Medicaid manual with general information for all provider types.
School-Based 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
October 2023 Schools Cover Sheet
July 2023 Schools Cover Sheet
July 2023 Schools Fee Schedule PDF
July 2023 Schools Fee Schedule Excel
October 2022 Schools Cover Sheet*
July 2022 Schools Cover Sheet
July 2022 Schools Fee Schedule PDF
July 2022 Schools Fee Schedule Excel
*Only the Coversheet changed from July 2022 to October 2022.
October 2021 Schools Cover Sheet*
July 2021 Schools Cover Sheet
July 2021 Schools Fee Schedule PDF Rev. 04/11/2022
July 2021 Schools Fee Schedule Excel Rev. 04/11/2022
*Only the Coversheet changed from July 2021 to October 2021.
January 2021 Cover Sheet Schools
January 2021 Fee Schedule Schools PDF Rev. 04/11/2022
January 2021 Fee Schedule Schools Excel Rev. 04/11/2022
October 2020 Schools Cover Sheet*
July 2020 Schools Cover Sheet rev. 09/28/2020
July 2020 Schools Fee Schedule PDF rev. 07/21/2020
July 2020 Schools Fee Schedule Excel rev. 07/21/2020
July 2020 CSCT Youth Mental Health Temporary FS rev. 11/06/2020
*Only the Coversheet changed from July 2020 to October 2020.
July 2023 Youth Mental Health Fee Schedule
May 2023 Medicaid Mental Health for Youth
July 2022 Temporary Medicaid Mental Health for Youth
July 2022 Medicaid Mental Health for Youth
October 2021 Medicaid Mental Health for Youth
July 2021 Temporary Medicaid Mental Health for Youth
July 2021 Medicaid Mental Health for Youth
January 2021 Temporary IOP Medicaid Mental Health for Youth
January 2021 Medicaid Mental Health for Youth
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
01/23/2024 Montana Healthcare Programs Support Services Holiday Closure REVISED
01/08/2024 Electronic Claim Adjustment Processing Change
12/22/2023 Passport Provider Referral Number on Claims
12/12/2023 Individual Providers Enrolled as Sole Proprietors Due for Revalidation
11/08/2023 Prior Authorization Information
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
10/25/2022 2022 FMAP Changes to the School-Based Services Fee Schedule
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
01/07/2022 Billing for Activities of Daily Living with Paraprofessionals
12/15/2021 Health Behavior Assessment and Intervention Billing Codes Rev. 04/26/2022
12/10/2021 New Provider Services Portal
09/24/2021 2021 FMAP Changes to the School Based Services Fee Schedule
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
04/02/2021 New Provider Type – Licensed Marriage and Family Therapist
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
12/07/2020 Medicaid Expansion Extended Through December 31, 2021
10/28/2020 Provider Relief Fund General Allocation
09/10/2020 2021 FMAP Changes to the School-Based Services Fee Schedule
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
07/20/2020 Outpatient Psychotherapy Limits
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
04/24/2020 Changes to Youth Community-Based Psychiatric Rehabilitation and Support Services
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
School Based ICD-10, Direct Care, and MAC 07/2019
This training applies to School Based service providers and the need to start coding ICD-10 diagnosis codes for October 1, 2015, dates of service forward. Refresher on Direct Care and MAC services are also included.
MAC Training (Coordination and Financial Officers) 07/2019
MAC Agreement Memorandum of Understanding 07/2019
This is the agreement that needs to be signed by the district representative and the state Medicaid Administrator in order for your district to participate in the Medicaid Administrative Claiming Program.
MAC Coordinators' Guide 10/2022
This guide provides a program overview for the person responsible for overseeing the implementation of the MAC program in the district or cooperative. It details how to prepare the participant listing, training time study participants, and managing the time study observation forms.
MAC Financial Data Guide 10/2022
This guide details the requirements for the financial data report necessary for submitting district expenditures in support of Medicaid services. MAC Time Study Guide 10/2022
This guide provides time study participants information and guidelines on how to complete the Random Moment Sample Time Study Observation forms. It gives details and examples of the activity codes. MAC Time Study Participant Training 03/2019
This presentation is designed to train the staff who will be participating in the RMS Time Study.
Participant Training Quiz 07/2019
This quiz can be used at the end of your training session to help participants code activities. It can be used individually or as a group discussion. This paper can also serve as your documentation of training to keep in your audit file.
Participant Training Quiz with Answers 07/2019
MAC Activity Code Reference Guide and Definitions 07/2019
This guide gives a detailed description of each activity code and provides examples of when the code should be used. Coordinators will find this useful when checking over the observation forms. This one-page definition of the activity codes should be copied onto the back of every Random Moment Observation form. It gives examples of when to use each activity code.