Prior Authorization Forms Claim Jumper Newsletters

General Information for Providers  

Medicaid manual with general information for all provider types.

Indian Health Service/Tribal 638 

This manual has information specific to your provider type.

Tribal Health Improvement Program (T-HIP) Manual 
This manual has information specific to your provider type.

Prescription Drug Program, Prior Authorization Chapter  

Prior authorization requirements and procedures are covered in this chapter.

Passport to Health 

How to become a successful Passport provider.


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
04/08/2021 Electronic Prior Authorization Process for Suboxone® Films for Medication Assisted Therapy
04/02/2021 New Provider Type – Licensed Marriage and Family Therapist
DME and DME EPSDT Prior Authorizations Through the Qualitrac Portal
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


12/23/2020 Diabetes Prevention Program (DPP) Information
12/07/2020 Medicaid Expansion Extended Through December 31, 2021 
12/01/2020 Change in Application Process for Plan First
11/17/2020 Prior Authorizations Through the Qualitrac Web Portal for DME and DME EPSDT
11/12/2020 Removal of Codes for COVID-19 Testing and Treatment
10/28/2020 Provider Relief Fund General Allocation

10/08/2020 Montana Plan First - Addition of Radiologic Examination Codes for Abdomen; 1, 2, and 3 Views
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
06/11/2020 Substance Use Disorder Billing Reminder
05/15/2020 Temporary Revision to Case Management General Provisions
05/01/2020 Telephone Services – Revenue Code 982
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

04/22/2020 Dental Telemedicine Notice
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
03/19/2020 Telemedicine Policy Clarification 

03/12/2020 Medical Food or Formula for Phenylketonuria (PKU) due to Inborn Errors of Metabolism (IEM) - HCPCS Code S9435
02/28/2020 Starting Dose and Quantity Limitations for Sedative Hypnotics
02/20/2020 Peer Support Services Revenue Code Update
01/03/2020 Changes to Hepatitis C Treatment Criteria



11/20/2018 Appropriate Billing Reminder
11/13/2018 Diabetes Prevention Program (DPP) Claims Update
11/08/2018 Rate Updates Mass Adjustment
10/19/2018 Medicaid Fee Schedules
7/24/2018 Diabetes Prevention Program (DPP) Coding Change
07/17/2018 Caregiver Depression Screenings Reissued Notice
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
02/19/2018 Medicaid State Plan Waiver Amendments
02/15/2018 Substance Use Disorder Billing
01/31/2018 Montana Healthcare Programs Covered Double Electric Breast Pumps - E0603

Montana Medicaid strives to improve billing capacity within Tribal and Indian Health Service clinics. DPHHS is committed to improving the health of the Indian population in Montana.

For Tribal or Indian Health Service billing questions contact:
The Tribal/IHS Program Specialist, 406.444.1292 or Jacqueline.Hart@mt.gov

Tribal/IHS Meeting Information


09/25/2018 Agenda Agenda September 25, 2018 Handouts/Information Community First Choice/Personal Assistance Services    Big Sky Waiver Overview
08/28/2018 Agenda Agenda August 28, 2018    Handouts/Information Enrollment Training in PDF
07/02/2018 Agenda Agenda June 26, 2018     Handouts/Information Medicaid Training in PDF
04/24/2018 Agenda Agenda April 24, 2018     Handouts/Information Medicaid Eligibility Refresher in PDF
02/27/2018 Agenda Agenda January 23, 2018 Handouts/Information Pharmacy Program in PDF
01/23/2018 Agenda Agenda January 23, 2018  Handouts/Information Diabetes Prevention Program in PDF
09/26/2017 Agenda Agenda September 26, 2017 Handouts/Information SURS PowerPoint in PDF
08/22/2017 Agenda Agenda August 22, 2017 Handouts/Information Clinical Laboratory Improvement Amendment
07/25/2017 Agenda Agenda July 25, 2017  Handouts/Information Medicaid Transportation FAQs
06/27/2017 Agenda Agenda June 27, 2017 Handouts/Information 2017 Passport Program
04/25/2017 Agenda
Agenda April 25, 2017   Handouts/Information 2017 HMK Overview
03/28/2017 Agenda Agenda March 28, 2017   Handouts/Information Medicaid Refresher
02/28/2017 Agenda Agenda February 28, 2017   Handouts/Information Telemedicine PowerPoint Slides in PDF and Medicare Savings Plan (MSP) Powerpoint Slides in PDF


T-HIP Member Opt Out Form 02/2019

T-HIP Provider Referral Form 02/2019

T-HIP Tier Request Form - Please request this form from the T-HIP Specialist at the Department.