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Severe Disabling Mental Illness

Prior Authorization Forms Claim Jumper Newsletters

Provider Manuals

General Information for Providers
Medicaid manual with general information for all provider types.

SDMI HCBS Waiver Manual
This link brings you to the Manual on the Department website.

Medicaid Rules and Regulations

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

Administrative Rules of Montana (Title 37)

Fee Schedules – HCBS for Adults with Severe Disabling Mental Illness (SDMI)

July 2022 HCBS for Adults with SDMI Rev. 07/07/2022

July 2021 HCBS for Adults with SDMI

July 2020 HCBS for Adults with SDMI

Provider Notices

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

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
01/13/2022 Change in Billing Provider Type for SDMI Waiver Providers

2021

12/15/2021 Health Behavior Assessment and Intervention Billing Codes Rev. 04/26/2022
12/10/2021 New Provider Services Portal
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
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
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

12/07/2020 Medicaid Expansion Extended Through December 31, 2021
10/28/2020 Provider Relief Fund General Allocation
8/28/2020 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

07/24/2020 Provider Relief Fund General Allocation

Overview and Access Guide for Seeking Provider Relief Funding from HHS Allocation to Medicaid Providers

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

FAQ for Suspension of Prior Authorizations or Continued Stay Reviews and Clinic 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

Frequently Asked Questions on Telemedicine / Telehealth

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

Other Resources

Prior Authorization Criteria for Specific Services

SURS Provider Self-Audit Protocol 02/2022

Additional Information for HCBS Providers is available on the DPHHS website.

Additional Information for Big Sky Waiver Providers is available on the DPHHS website.

Additional Information for SDMI Providers is available on the DPHHS website.

Additional Information for Children's Mental Health Providers is available on the DPHHS website.

To locate older documents, access the Archive Page.