website postings by week for 2019...website postings by week for 2019 these documents are available...

Website Postings by Week for 2019 These documents are available on the Montana Healthcare Programs Provider Website

December 27, 2019

Page/Provider

Item

Date Approved Date

Posted Document Date

• Hospital Inpatient Critical Access Hospital Manual 12/23/2019 12/23/2019 01/01/2020

• FQHC • RHC

FQHC/RHC Manual 12/23/2019 12/23/2019 01/01/2020

• Audiology • Hearing Aids

Audiology Manual 12/23/2019 12/23/2019 01/01/2020

• DME DEM Manual 12/23/2019 12/23/2019 01/01/2020

• Hospital Inpatient Hospital Inpatient Manual 12/23/2019 12/23/2019 01/01/2020

• Hospital Outpatient Hospital Outpatient Manual 12/23/2019 12/23/2019 01/01/2020

• Indian Health Service

Indian Health Service Manual 12/23/2019 12/23/2019 01/01/2020

• EPSDT • Nutrition

Nutrition Manual 12/26/2019 12/26/2019 01/01/2020

• Optometric • Optician • Eyeglasses

Optometric Manual 12/26/2019 12/26/2019 01/01/2020

• Physician • Mid-Levels • Pharmacy • Indian Health

Service

Provider Notice Prior Authorization Criteria for Atypical Antipsychotics for Children 7 Years of Age and Under

12/26/2019 12/26/2019 01/01/2020

• EPSDT Orientation and Mobility Manual 12/26/2019 12/26/2019 01/01/2020

• Proposed Fee Schedules

January 2020 AmbulanceProposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020

Proposed Fee Schedules

January 2020 Dental Hygienist Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Dental Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Denturist Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Direct Entry Midwife Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 DME Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Hearing Aid Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 IDTF Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Laboratory Services Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020

https://medicaidprovider.mt.gov/


Website Postings by Week for 2019

These documents are available on the Montana Healthcare Programs Provider Website

Page/Provider

Item

Date Approved Date



January 2020 Mid-Levels Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Mobile Imaging Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Oral Surgeon Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Optician Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Optometric Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Podiatry Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Physician Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Psychiatrist Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 Public Health Proposed Fee Schedule and Coversheet

12/26/2019 12/26/2019 01/01/2020


January 2020 RBRVS Proposed Fee Schedule 12/26/2019 12/26/2019 01/01/2020

• EPSDT • Private Duty Nursing

Private Duty Nursing Manual 12/27/2019 12/27/2019 01/01/2020

• Occupational Therapy

• Physical Therapy • Speech Therapy

Therapies Manual 12/27/2019 12/27/2019 01/01/2020

• Schools School-Based Services Manual 12/27/2019 12/27/2019 01/01/2020

• All Provider General Manual 12/27/2019 12/27/2019 01/01/2020

• All Providers Provider Notice Elimination of Copayments

12/27/2019 12/27/2019 12/27/2019

• Home Page • Announcements

Elimination of Copayments Announcement 12/27/2019 12/27/2019 12/27/2019


Elimination of Copayments FAQs 12/27/2019 12/27/2019 12/27/2019




December 20, 2019

Page/Provider

Item

Date Approved Date


• Hospital Inpatient APR-DRG FAQ Revised 12/16/2019 12/16/2019 12/16/2019

• Pharmacy Provider Notice Guidance for Pharmacies Billing Prescriptions for Members in Psychiatric Residential Treatment Facilities (PRTF)

12/17/2019 12/17/2019 12/13/2019

• Training Page Audiology Training PowerPoint in PDF 12/19/2019 12/19/2019 12/19/2019

• Optometric • Optician • Eyeglasses

Optometric/Eyeglasses FAQ Revised 12/20/2019 12/20/2019 12/20/2019

• Passport Passport Disenrollment Form Revised 12/20/2019 12/20/2019 12/20/2019




December 13, 2019

Page/Provider

Item

Date Approved Date



October 2019 Hospice Compliant (Revised) 12/9/2019 12/9/2019 10/01/2019


October 2019 Hospice Non-Compliant (Revised) 12/9/2019 12/9/2019 10/01/2019

• State Approved Substance Use Disorder Programs

Provider Notice DLA-20 for Intensive Outpatient Treatment (IOP) Programs

12/10/2019 12/10/2019 12/10/2019

• Pharmacy • Site Index

December 2019 MT PDL 12/10/2019 12/10/2019 12/10/2019




December 6, 2019

Page/Provider

Item

Date Approved Date


• CJ Newsletters December 2019 Claim Jumper 12/02/2019 12/02/2019 12/01/2019

• Hospital In-Patient APR-DRG FAQs 12/02/2019 12/02/2019 11/27/2019

• Pharmacy • Mid-Levels • Physicians • IHS/Tribal 638

Provider Notice Dosage Restrictions for all Opioids based on Morphine Milligram Equivalents (MME)

12/04/2019 12/04/2019 12/04/2019

• Passport PCCM Member Disenrollment Form (New) 12/05/2019 12/05/2019 12/05/2019

• Passport PCCM Disenrollment Form Instructions (New) 12/05/2019 12/05/2019 12/05/2019

• Forms EPSDT Prior Authorization Form (Revised) 12/06/2019 12/06/2019 12/04/2019

• Home & Community Based Waivers

• Mental Health Centers

• Out of State Hospital Inpatient

• PRTF • State-Approved SUD • Therapeutic Group

Homes

Provider Notice New UR Implementation Date and Provider Portal Training

12/06/2019 12/06/2019 12/06/2019

• School-Based Services

July Fee Schedule in PDF and Excel re-posted under the October 2019 Fee Schedule per program officer.

12/06/2019 12/06/2019 07/01/2019

• Pharmacy – DUR DUR Minutes September 25, 2019 12/06/2019 12/06/2019 09/25/2019

• Pharmacy – DUR DUR Minutes October 30, 2019 12/06/2019 12/06/2019 10/30/2019




November 29, 2019

No Postings This Week.




November 22, 2019

Page/Provider

Item

Date Approved Date


• All Providers Provider Notice HCPS Modifiers – XE, XP,XS, XU

11/18/2019 11/18/2019 11/18/2019

• Home & Community Based Waivers


• Out-Of-State Hospital Inpatient

• PRTF • State-Approved SUD • Therapeutic Group

Homes

Provider Notice New UR Introduction and Training Information

11/18/2019 11/18/2019 11/18/2019

• All Providers General Manual Revised 11/19/2019 11/19/2019 11/15/2019

Training FQHC/RHC Training PowerPoint in PDF 11/21/2019 11/21/2019 11/21/2019

• Hospital Inpatient • Hospital Outpatient • EPSDT • Private Duty Nursing • DME • Mid-Levels • Physician • Home Health

Agencies • Ambulance

Provider Notice New Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Review and Process through Qualitrac Portal

11/22/2019 11/22/2019 11/22/2019




November 15, 2019

Page/Provider

Item

Date Approved Date


• Training • Home • Registration

January, February, and March 2020 online trainings posted and added to registration data capture

11/13/2019 11/13/2019 N/A

• DME • EPSDT • IHS/Tribal 692

Provider Notice Daily Supply Kit by Day for Enteral Feeding (B4034, B4035, B4036)

11/13/2019 11/13/2019 11/13/2019

• All Provider Types REMOVED the following provider notices: • 10/01/2019 Chronic Care/Coordinated

Care Codes • 07/25/2019 Cognitive Care

Reimbursement • 06/28/2019 Cognitive Care

Reimbursement

11/12/2019 11/14/2019 10/01/2019 07/25/2019 06/28/2019

• Physician • Hospital Inpatient • Hospital Outpatient • FQHC • RHC • ASC • Mid-Levels

Provider Notice (Re-issued from 2016) Circumcision Prior Authorization Changes

11/14/2019 11/14/2019 11/14/2019

• CAH • Hospital Inpatient • Hospital Outpatient • Mid-Levels • Pharmacy • Physicians

Provider Notice Prior Authorization Criteria for Synagis®

11/14/2019 11/14/2019 11/14/2019

• CPC+ • FQHC • Hospital Inpatient • Hospital Outpatient • Mid-Levels • PCMH • Physician • Psychiatrist • RHC

Provider Notice Chronic Care Codes Revised

11/15/2019 11/15/2019 11/12/2019




November 8, 2019

Page/Provider

Item

Date Approved Date


• Medicaid Statistics Medicaid Statistics July 1, 2018 – June 30, 2019 added

11/04/2019 11/04/2019 06/30/2019




November 1, 2019

Page/Provider

Item

Date Approved Date


• Hospital Inpatient Fee Schedule October 2019 APC in PDF and Excel revised

10/30/2019 10/31/2019 10/01/2019

• Hospital Inpatient Fee Schedule October 2019 OPPS in PDF and Excel revised

10/30/2019 10/31/2019 10/01/2019

• Hospital Inpatient Fee Schedule July 2019 OPPS in PDF and Excel revised

10/30/2019 10/31/2019 07/01/2019




October 25, 2019

Page/Provider

Item

Date Approved Date


• Pharmacy Provider Notice Pharmacy Provider License Renewal Reminder

10/21/2019 10/21/2019 10/18/2019

• FQHC • RHC • Tribal 638

Provider Notice REMOVED Peer Support Services

10/21/2019 10/21/2019 07/23/2019

• Hospital Outpatient Fee Schedule & Coversheet in PDF & Excel October 2019 APC Fee Schedule

10/23/2019 10/23/2019 10/01/2019

• Hospital Outpatient Fee Schedule & Coversheet in PDF & Excel October 2019 OPPS Fee Schedule

10/23/2019 10/23/2019 10/01/2019

• Hospital Inpatient Fee Schedule in Excel October 2019 APR-DRG Calculator (revised)

10/25/2019 10/25/2019 10/01/2019




October 18, 2019

Page/Provider

Item

Date Approved Date


• Laboratory Services July 2019 Laboratory Services Fee Schedule in PDF and Excel Revised

10/14/2019 10/14/2019 07/01/2019

• Mid-Levels July 2019 Mid-Levels Fee Schedule in PDF and Excel Revised

10/14/2019 10/14/2019 07/01/2019

• Physician July 2019 Physician Fee Schedule in PDF and Excel Revised

10/14/2019 10/14/2019 07/01/2019

• Pharmacy DUR DUR B Agenda October 30, 2019 10/16/2019 10/16/2019 10/30/2019

• Pharmacy DUR DUR B Minutes September 25, 2019 10/17/2019 10/17/2019 09/25/2019

• Training Optometric/Eyeglasses PowerPoint 10/17/2019 10/17/2019 10/17/2019




October 11, 2019

Page/Provider

Item

Date Approved Date


• Chemical Dependency

Provider Notice Continued Stay Requirements for Substance Use Disorder (SUD) Intensive Out Patient Services (ASAM 2.1) Adult And Adolescent Are Temporarily On Hold Until Further Notice

10/10/2019 10/10/2019 10/10/2019

• ASC Fee Schedule & Coversheet in PDF and Excel October 2019 ASC

10/10/2019 10/10/2019 10/01/2019




October 4, 2019

Page/Provider

Item

Date Approved Date


• Newsletters October 2019 Claim Jumper 09/30/2019 09/30/2019 10/01/2019

• All Providers Provider Notice Chronic Care Coordinated Care Codes

10/01/2019 10/01/2019 09/24/2019

• IHS July 2019 IHS Fee Schedule 10/01/2019 10/01/2019 07/01/2019 • School Based

Services October 2019 School Based Services Cover Sheet

09/30/2019 10/01/2019 10/01/2019

• Site Index • Hospital Inpatient • Hospital Outpatient • Podiatrist • ASC • Family Planning • Pharmacy • Optometric • Ambulance • Physicians • Laboratory Services • Mid-Levels • Eyeglasses • Dialysis Clinic • Psychiatrist • Clinical Pharmacist • Mobile Imaging • Licensed Direct

Entry Midwife

October 2019 Quarterly Rebateable Labelers 10/01/2019 10/01/2019 10/01/2019


Proposed October 2019 HCBS for Adults With SMI Fee Schedule

10/03/2019 10/03/2019 10/10/2019


Proposed October 2019 Physically Disabled HCBS Waiver Service Coversheet

10/03/2019 10/03/2019 10/10/2019


Proposed October 2019 Physically Disabled HCBS Waiver Service Fee Schedule

10/03/2019 10/03/2019 10/10/2019

• FAQs New Enrollment FAQ – for Requirements for Business Purchases

10/04/2019 10/04/2019 10/04/2019

• Provider Enrollment • Provider File

U d t

Requirements For Business Purchases 10/04/2019 10/04/2019 10/04/2019

• FQHC • RHC • IHS

Provider Notice Peer Support Services

10/04/2019 10/04/2019 10/04/2019




September 27, 2019

Page/Provider

Item

Date Approved Date


• Dental Services • Dental Hygienist • Denturist

Provider Manual 09/23/2019 09/23/2019 10/01/2019

• Hospital Outpatient APC Coversheet July 2019 09/24/2019 09/24/2019 07/01/2019

• Hospital Outpatient OPPS Coversheet July 2019 09/24/2019 09/24/2019 07/01/2019


PDL 09/24/2019 09/24/2019 09/25/2019

• FQHC • RHC

FQHC/RHC Fee Schedule Sections Removed 09/25/2019 09/26/2019 N/A

• Dental Services October 2019 Dental Fee Schedule in PDF and Excel Revised

09/26/2019 09/27/2019

09/26/2019 09/27/2019

10/01/2019 10/01/2019

• Hospital Inpatient Provider Notice Reimbursement Rate Change

09/27/2019 09/27/2019 09/26/2019

Page/Provider

Item

Date Approved Date



Provider Manual 09/23/2019 09/23/2019 10/01/2019




PDL 09/24/2019 09/24/2019 09/25/2019

• FQHC • RHC



09/26/2019 09/27/2019

09/26/2019 09/27/2019

10/01/2019 10/01/2019


09/27/2019 09/27/2019 09/26/2019

Page/Provider

Item

Date Approved Date



Provider Manual 09/23/2019 09/23/2019 10/01/2019




PDL 09/24/2019 09/24/2019 09/25/2019

• FQHC • RHC



09/26/2019 09/27/2019

09/26/2019 09/27/2019

10/01/2019 10/01/2019


09/27/2019 09/27/2019 09/26/2019




September 20, 2019

Page/Provider

Item

Date Approved Date


• Mid-Levels Fee Schedule July 2019 Mid Level in Excel and PDF Revised

09/17/2019 09/17/2019 07/01/2019

• Physician Fee Schedule July 2019 Physician in Excel and PDF Revised

09/17/2019 09/17/2019 07/01/2019

• Psychiatrist Fee Schedule July 2019 Psychiatrist in Excel and PDF Revised

09/17/2019 09/17/2019 07/01/2019

• Public Health Fee Schedule July 2019 Public Health in Excel and PDF Revised

09/17/2019 09/17/2019 07/01/2019


Fee Schedule October 2019 Medicaid SUD

09/19/2019 09/20/2019 10/01/2019


Fee Schedule October 2019 Non-Medicaid SUD

09/19/2019 09/20/2019 10/01/2019

• Social Worker • Psychologist • PRTF • School-Based

Services • Licensed

Professional Counselor

• Mental Health Center

• Targeted Case Management

• Therapeutic Group Home

• Therapeutic Foster Home

Fee Schedule October 2019 Adult Mental Health

09/19/2019 09/20/2019 10/01/2019

• Training CSCT PowerPoint in PDF 09/19/2019 09/19/2019 09/19/2019

• Dental Fee Schedule & Cover Sheet October 2019 Dental Services in Excel and PDF

09/20/2019 09/20/2019 10/01/2019




• Oral Surgeon Fee Schedule & Cover Sheet October 2019 Oral Surgeon in Excel and PDF

09/20/2019 09/20/2019 10/01/2019




September 13, 2019

Page/Provider

Item

Date Approved Date


• DDP Montana Provider Portal User Guide Revised 09/10/2019 09/10/2019 09/09/2019

• Physicians • Mid-Levels • Psychiatrists

Provider Notice Medication-Assisted Treatment (MAT) Bundled Rates

09/11/2019 09/11/2019 09/11/2019

• Dental Services Fee Schedule & Coversheet in PDF and Excel July 2019 Dental Services Revised

09/13/2019 09/13/2019 07/01/2019

• Dental Services Fee Schedule in PDF and Excel July 2019 Dental Hygienist Revised

09/13/2019 09/13/2019 07/01/2019




September 6, 2019 No Documents Posted This Week.




August 30, 2019

Page/Provider

Item

Date Approved Date


• Pharmacy DUR DURB Agenda September 2019 08/23/2019 08/26/2019 09/25/2019

• Dental Fee Schedule July 2019 Dental Hygienist Fee Schedule Revised

08/26/2019 08/26/2019 07/01/2019

• Contact Us Contact Us Page Re—Design Two pane sets were combined into one to make searching easier for providers

08/27/2019 08/27/2019 08/27/2019

• Forms PA Form for Suboxone Films for Medication Assisted Therapy Revised

08/27/2019 08/27/2019 08/27/2019

• Pharmacy • Mid-Levels • Physicians

Provider Notice and Form Revised Electronic Authorization Process for Suboxone Films for Medication Assisted Therapy

08/27/2019 08/27/2019 08/27/2019

• Pharmacy NCPDP Payer Sheet Revised 08/28/2019 08/28/2019 08/28/2019

• Presumptive Eligibility

Updated Training Dates 08/29/2019 08/29/2019 08/29/2019

• Newsletters September 2019 Claim Jumper 08/29/2019 08/30/2019 09/01/2019




August 23, 2019 Page/Provider

Item

Date Approved Date


• IHS/Tribal 638 • Passport

Provider Notice Managed Care Referrals

08/22/2019 08/22/2019 08/22/2019




August 16, 2019 Page/Provider

Item

Date Approved Date


• Home Page • Announcements • Pharmacy

Pharmacy Announcement 08/15/2019 08/15/2019 08/15/2019

• Training Billing 101 PowerPoint 08/15/2019 08/15/2019 08/15/2019


IVR Announcement 08/16/2019 08/16/2019 08/16/2019




August 9, 2019

Page/Provider

Item

Date Approved Date


• DDP Draft 2019 DDP Fee Schedule in PDF and Excel 08/05/2019 08/05/2019 07/01/2019

• Survey Updated Provider Survey 08/07/2019 07/07/2019 07/07/2019

• FQHC • RHC

Provider Notice FQHC & RHC Fee Schedule Reminder

08/08/2019 08/08/2019 08/08/2019

• Dental Services • Oral Surgeon • Denturist • Proposed Fee

Schedule

Proposed Dental Services Manual 08/08/2019 08/08/2019 10/01/2019


Rule Hearing Information for 08/29/2019 08/08/2019 08/08/2019 08/08/2019


October 2019 Mental Health Fee Schedule 08/08/2018 08/08/2018 10/01/2019


October 2019 APR-DRG Fee Schedule 08/08/2018 08/08/2018 10/01/2019


October 2019 Dental Services Fee Schedule and Cover Sheet

08/08/2018 08/08/2018 10/01/2019


October 2019 Medicaid SUD Fee Schedule 08/08/2018 08/08/2018 10/01/2019


October 2019 Non-Medicaid SUD Fee Schedule 08/08/2018 08/08/2018 10/01/2019


October 2019 Oral Surgeon Fee Schedule and Cover Sheet

08/08/2018 08/08/2018 10/01/2019




August 2, 2019

Page/Provider

Item

Date Approved Date


• Newsletters August 31, 2019 07/31/219 07/31/2019 08/01/2019

• Training • DDP

DDP Training PowerPoint (in PDF) 08/02/2019 08/02/2019 08/02/2019

• DDP MPATH Provider Services Claims Entry Solution link

08/02/2019 08/02/2019 08/02/2019

• DDP Montana Provider portal User Guide 08/02/2019 08/02/2019 08/02/2019

• DDP Provider Notice Developmental Disabilities Program MMIS Transition

08/02/2019 08/02/2019 08/05/2019




July 26, 2019

Page/Provider

Item

Date Approved Date


• Optometric July 2019 Optometric Fee Schedule (Revised twice)

07/19/2019 07/23/2019

07/21/2019 07/23/2019

07/01/2019 07/01/2019

• FQHC • RHC

FQHC/RHC Manual Revised (Revised How Payment is Calculated Chapter)

07/22/2019 07/22/2019 07/22/2019

• DME • IHS/Tribal 638 • Physicians • Mid-Levels

Provider Notice Therapeutic Continuous Glucose Monitor and Sensors – K0554 & K0553

07/23/2019 07/23/2019 07/23/2019

• FQHC • RHC • IHS/Tribal 638

Provider Notice Peer Support Services

07/23/2019 07/23/2019 07/23/2019

• All Providers Provider Notice Cognitive Care Services – Revised

07/25/2019 07/25/2019 07/25/2019

• FQHC • RHC

FQHC/RHC Manual Revised Billing Procedures Chapter Revised

07/26/2019 07/26/2019 07/26/2019




July 19, 2019 Page/Provider

Item

Date Approved Date


• DDP DDP Manual 07/15/2019 07/16/2019 07/2019

• ASC July 2019 ASC Fee Schedule & Coversheet in PDF and Excel

07/17/2019 07/17/2019 07/01/2019

• Hospital Outpatient July 2019 OPPS Fee Schedule & Coversheet in PDF and Excel

07/17/2019 07/17/2019 07/01/2019

• Hospital Outpatient July 2019 APC Fee Schedule & Coversheet in PDF and Excel

07/17/2019 07/17/2019 07/01/2019

• Training Online Training Provider Website Navigation PowerPoint Slides in PDF

07/18/2019 07/18/2019 07/18/2019

• Training Online Training MATH Web Portal PowerPoint Slides in PDF

07/18/2019 07/18/2019 07/18/2019




July 12, 2019 Page/Provider

Item

Date Approved Date


• Audiology July 2019 Audiology Coversheet & Fee Schedule in PDF and Excel

07/08/2019 07/08/2019 07/01/2019

• DME July 2019 DME Coversheet & Fee Schedule in PDF and Excel

07/08/2019 07/08/2019 07/01/2019

• Hearing Aid July 2019 Hearing Aid Coversheet & Fee Schedule in PDF and Excel

07/08/2019 07/08/2019 07/01/2019

• Dental Hygienist July 2019 Dental Hygienist Coversheet & Fee Schedule in PDF and Excel

07/08/2019 07/08/2019 07/01/2019

• Dental Services July 2019 Dental Services Coversheet & Fee Schedule in PDF and Excel

07/08/2019 07/08/2019 07/01/2019

• Denturist July 2019 Denturist Coversheet & Fee Schedule in PDF and Excel

07/08/2019 07/08/2019 07/01/2019

• Oral Surgeon July 2019 Oral Surgeon Coversheet & Fee Schedule in PDF and Excel

07/08/2019 07/08/2019 07/01/2019

• Pharmacy • Physicians • Mid-Levels • FQHC

Prescription Drug Manual - Revised

07/08/2019 07/08/2019 07/08/2019

• Physicians • Mid-Levels • Pharmacy • IHS

Provider Notice Vaccine Administration by Pharmacists

07/09/2019 07/09/2019 07/09/2019

• Physicians • Mid-Levels • Hospital Outpatient • CAH

Provider Notice Consent for Sterilization Form

07/10/2019 07/10/2019 07/10/2019

• Ambulance July 2019 Ambulance Coversheet & Fee Schedule in PDF and Excel

07/10/2019 07/10/2019 07/01/2019

• Physician July 2019 Physician Fee Schedule in PDF and Excel

07/10/2019 07/10/2019 07/01/2019

• Enrollment Full Enrollment Paper Application – Revised (updated email addresses)

07/10/2019 07/10/2019 07/10/2019

• Enrollment Rendering Enrollment Paper Application – Revised (updated email addresses)

07/10/2019 07/10/2019 07/10/2019




Page/Provider

Item

Date Approved Date


• Enrollment Limited Enrollment Paper Application – Revised (updated email addresses)

07/10/2019 07/10/2019 07/10/2019

• Enrollment Cover Letter and Checklist – Revised (updated email addresses)

07/10/2019 07/10/2019 07/10/2019




July 5, 2019

Page/Provider

Item

Date Approved Date


• Family Planning Clinic

• FQHC • Inpatient Hospital • Outpatient Hospital • ASC • RHC • Mid-Levels • Pharmacy • Public Health Clinics • Plan First

Provider Notice and Code List Montana Plan First – Update to Covered Code List

07/02/2019 07/02/2019 07/05/2019

• Plan First July 2019 Plan First Service Codes 07/02/2019 07/02/2019 07/05/2019

• Dental Fee Schedule HMK Dental

07/03/2019 07/03/2019 07/01/2019

• Mid-Level July 2019 Mid-Level Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019

• Physician July 2019 Physician Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019

• Podiatry July 2019 Podiatry Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019

• Hospital Outpatient • CAH

Provider Notice Frequently Asked Hospital Laboratory Services Questions

06/28/2019 07/02/2019 06/11/2019

• Direct Entry Mid-Wife

July 2019 Direct Entry Mid-Wife Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019

• Psychiatrist July 2019 Psychiatrist Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019


July 2019 School-Based Services Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019

• IDTF July 2019 IDTF Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019

• Laboratory Services • Hospital Outpatient

July 2019 Laboratory Services Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019




Page/Provider

Item

Date Approved Date


• Public Health Services

July 2019 Public Health Services Fee Schedule in PDF and Excel and Cover Sheet

07/03/2019 07/03/2019 07/01/2019

• Occupational Therapy Services

July 2019 Occupational Therapy Fee Schedule in PDF and Excel and Cover Sheet

07/05/2019 07/05/2019 07/01/2019

• Optician July 2019 Optician Fee Schedule in PDF and Excel and Cover Sheet

07/05/2019 07/05/2019 07/01/2019

• Optometrics July 2019 Optometrics Fee Schedule in PDF and Excel and Cover Sheet

07/05/2019 07/05/2019 07/01/2019

• Physical Therapy July 2019 Physical Therapy Fee Schedule in PDF and Excel and Cover Sheet

07/05/2019 07/05/2019 07/01/2019

• Speech Therapy July 2019 Speech Therapy Fee Schedule in PDF and Excel and Cover Sheet

07/05/2019 07/05/2019 07/01/2019




June 28, 2019

Page/Provider

Item

Date Approved Date


• Psychologist • PRTF • Social Worker • School-Based

Services • License Professional

Counselor • Mental Health

Centers • TCM – Mental

Health • Therapeutic Group

Home • Therapeutic Foster

Home

July 2019 72 Hour Fee Schedule 06/25/2019 06/25/2019 07/01/2019







Home

July 2019 Adult Mental Health Fee Schedule 06/25/2019 06/25/2019 07/01/2019







Home

July 2019 HCBS for Adults w/ SDMI Fee Schedule

06/25/2019 06/25/2019 07/01/2019




Page/Provider

Item

Date Approved Date








Home

July 2019 MHSP Fee Schedule 06/25/2019 06/25/2019 07/01/2019


July 2019 SUD Medicaid Fee Schedule 06/25/2019 06/25/2019 07/01/2019


July 2019 Non-Medicaid Fee Schedule 06/25/2019 06/25/2019 07/01/2019

• TCM-Mental Health July 2019 TCM – Mental Health Fee Schedule in PDF and Excel and Cover Sheet

06/25/2019 06/25/2019 07/01/2019

• Site Index July 2019 RBRVS

06/26/2019 06/26/2019 07/01/2019

• Audiology July 2019 Audiology Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• EPSDT July 2019 Children’s Special Health Services Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Children’s Chiropractic

July 2019 Children’s Chiropractic Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Dental July 2019 Dental Hygienist Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Dental July 2019 Dental Services Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Denturist July 2019 Denturist Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019




Page/Provider

Item

Date Approved Date


• Hearing Aid Services July 2019 Hearing Aid Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Laboratory Services • Physician

July 2019 Laboratory Services Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• DME July 2019 DME Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Home Infusion July 2019 Home Infusion Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Mobile Imaging July 2019 Mobile Imaging Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019



06/26/2019 06/26/2019 07/01/2019

• Optician Services July 2019 Optician Services Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Mobile Imaging Services

July 2019 Mobile Imaging Services Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• EPSDT • Nutritionist

July 2019 Nutrition Services Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019



06/26/2019 06/26/2019 07/01/2019

• Optometric Services July 2019 Optometric Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Optician July 2019 Optician Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Oral Surgeon July 2019 Oral Surgeon Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• EPSDT July 2019 Orientation and Mobility Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019




Page/Provider

Item

Date Approved Date


• EPSDT • Private Duty Nursing

July 2019 Private Duty Nursing Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Speech Therapy July 2019 Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Physical Therapy July 2019 Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Transportation – Personal and Commercial

July 2019 Personal and Commercial Transportation Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• TCM – Non Mental Health

July 2019 Targeted Case Management – Non Mental Health Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Transportation – Non Emergency Specialized Services

July 2019 Transportation – Non Emergency Specialized Services Fee Schedule in PDF and Excel and Cover Sheet

06/26/2019 06/26/2019 07/01/2019

• Hospital In-Patient April 2019 OPPS Fee Schedule, Revised 06/26/2019 06/26/2019 04/01/2019


Updated Training Dates 06/26/2019 06/26/2019 06/26/2019

• All Providers Provider Notice Cognitive Care Reimbursement

06/27/2019 06/27/2019 06/26/2019




June 21, 2019 Page/Provider

Item

Date Approved Date


• Newsletters July 2019 Claim Jumper 06/17/2019 06/17/2019 07/01/2019

• Forms Federal Consent for Sterilization Revised 06/20/2019 06/20/2019 06/20/2019

• Pharmacy • Mid-Levels • Physician

Provider Notice Electronic Prior Authorization Process for Suboxone Films for Medication Assisted Therapy

06/21/2019 06/21/2019 06/20/2019

• Forms Buprenorphine/Naloxone MAT Attestation Form

06/21/2019 06/21/2019 06/20/2019




June 14, 2019

Page/Provider

Item

Date Approved Date



PDL 06/11/2019 06/11/2019 06/11/2019


Proposed July Dental Fee Schedule Revised 06/12/2019 06/12/2019 07/01/2019

• Hospital Inpatient • Hospital Outpatient • CAH

Provider Notice Unlisted billing Codes Reminder

06/12/2019 06/12/2019 06/11/2019




June 7, 2019 Page/Provider

Item

Date Approved Date


• All Mental Health Providers

Provider Notice Reminder – Comprehensive School and Community Treatment (CSCT) Summer Program Requirements

06/06/2019 06/06/2019 06/05/2019




May 31, 2019 Page/Provider

Item

Date Approved Date


• End User Agreement– Claim Jumper

Updated CMS Language 05/28/2109 05/28/2109 05/28/2109

• End User Agreement– Enhanced Payment


• End User Agreement– Government Rights


• End User Agreement–Proposed Fee Schedules


• End User Agreement–RBRVS


• End User Agreement–RBRVS VS


• End User Agreement–Providers


• All Provider Type Manuals

Complete Manual Tab moved from the bottom to the top of the manuals

05/28/2019 05/29/2019 05/28/2019

• All Provider Types Provider Notice Revised Nurse Visit Appropriate Billing Reminder Revised

05/31/2019 05/31/2019 05/31/2019

• Hospital In-Patient Fee Schedule April 2019 OPPS Revised

05/30/2019 05/30/2019 04/01/2019


Proposed Dental Fee Schedule July 2019 05/30/2019 05/30/2019 07/01/2019


Proposed Oral Surgeon Fee Schedule July 2019 05/30/2019 05/30/2019 07/01/2019





Item

Date Approved Date


• All Providers Provider Notice Nurse Visit – Appropriate Billing Reminder – Revised Clarification

05/20/2019 05/20/2019 05/17/2019

• Newsletters June 2019 Claim Jumper 05/20/2019 05/20/2019 06/01/2019


Hearing Language for Proposed July 2019 Fee Schedules

05/232019 05/23/2019 05/23/2019


Proposed Fee Schedule July 2019 Home Infusion

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Children’s Mental Health

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 TCM – Mental Health

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Occupational Therapy

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Physical Therapy

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Speech Therapy

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Audiology

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Hearing Aid

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 DME

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Orientation & Mobility

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Psychiatrist

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Private Duty Nursing

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 TCM Non-Mental Health

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Children’s Chiropractic

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 CSHS Services

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Nutrition

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Optometric

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Optician

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Ambulance

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Dental Hygienist

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Dental Services

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Denturist

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Oral Surgeon

05/23/2019 05/23/2019 07/01/2019




Page/Provider

Item

Date Approved Date



Proposed Fee Schedule & Coversheet July 2019 Transportation – Non Emergency Specialized Services

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Transportation PCS Services

05/23/2019 05/23/2019 07/01/2019


Proposed Fee ScheduleJuly 2019

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 RBRVS

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 PAS Services

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 CFC Services

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Home Health

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Laboratory Services

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Mid-Levels

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Mobile Imaging

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Physician

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Podiatry

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Public Health

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Direct Entry Mid-Life

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 IDTF

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule & Coversheet July 2019 Elderly & Physically Disabled Big Sky Waiver

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule July 2019 72-Hour

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule July 2019 HCBS Adults with SDMI

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule July 2019SUD Non-Medicaid

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule July 2019 Adult Medicaid Mental Health

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule July 2019 MHSP

05/23/2019 05/23/2019 07/01/2019


Proposed Fee Schedule July 2019 SUD Medicaid

05/23/2019 05/23/2019 07/01/2019





Item

Date Approved Date


• Pharmacy DUR Mayzent® Medicaid Dossier 05/13/2019 5/13/2019 5/13/2019

• Mid-Levels Fee Schedule January 2019 Mid-Levels Revised

05/16/2019 05/16/2019 01/01/2019

• Oral Surgeon Fee Schedule July 2018 Oral Surgeon Revised

05/17/2019 05/17/2019 07/01/2019





Item

Date Approved Date

Poste

Document Date

• All Providers General Manual Revised 05/06/2019 05/06/2019 05/03/2019

• Dental Provider Notice Dental Blanket Denial Process

05/06/2019 05/06/2019 05/06/2019

• Site Index • Pharmacy

MT Quarterly PDL 05/07/2019 05/07/2019 05/07/2019

• ASC Fee Schedule & Coversheet ASC April 2019

05/09/2019 05/09/2019 04/01/2019

• Physician • Mid-Levels • Hospital Outpatient • CAH • ASC • IDTF

Provider Notice NDC Required on All Radiopharmaceuticals

05/10/2019 05/10/2019 05/13/2019

• Hospital Outpatient Fee Schedule & Coversheet APC April 2019 Fee Schedule

05/10/2019 05/10/2015 04/01/2019

• Hospital Outpatient Fee Schedule & Coversheet OPPS April 2019 Fee Schedule

05/10/2019 05/10/2015 04/01/2019

• Hospital Inpatient APR-DRG Calculator Revised 05/10/2019 05/10/2015 01/01/2019





Item

Date Approved Date


• Hospital Inpatient APR-DRG January 2019 revised 04/29/2019 04/29/2019 01/01/2019

• All Provider Types Updated MCA/Legislative links in the Medicaid Rules and Regulations panes

04/30/2019 04/30/2019 04/30/2019

• Pharmacy • Physicians • Mid-Levels

Provider Notice Dosage Restrictions for all Opioids Based on Morphine Milligram Equivalents (MME)

05/01/2019 05/01/2019 05/01/2019

• All Mental Health Providers

Provider Notice Outpatient Psychotherapy Limits

05/02/2019 05/02/2019 05/01/2019

• Oral Surgeon Oral Surgeon Fee Schedule V2 July 2018 revised

05//02/2019 05/02/2019 07/01/2018




April 26, 2019 Page/Provider

Item

Date Approved Date



January 2019 School Based Services Fee Schedule – Revised

04/22/2019 04/22/219 01/01/2019

• Pharmacy DUR April 2019 DUR Meeting Minutes 04/22/2019 04/23/2019 04/17/2019





Item

Date Approved Date


• DME January 2019 DME Fee Schedule revised 04/15/2019 04/15/2019 01/01/2019

• Pharmacy Provider Notice 2019 AAC Survey

04/15/2019 04/15/2019 04/15/2019

• Pharmacy Provider Notice 2019 Annual Montana Dispensing Fee Survey

04/16/2019 04/16/2019 04/16/2019

• WebEx • Training • Home

Added Web Navigation WebEx Registration for July 2019

04/17/2019 04/17/2019 07/18/2019

• Training SURS Training PowerPoint (in PDF) 04/18/2019 04/18/2019 04/18/2019

• Pharmacy DUR DUR Board Meeting Agenda May 22, 2019 04/19/2019 04/19/2019 05/22/2019





Item

Date Approved Date


• Physician January 2019 Physician Fee Schedule - Revised

04/10/2019 04/11/2019 01/01/2019

• Psychiatrist January 2019 Psychiatrist Fee Schedule - Revised

04/10/2019 04/11/2019 01/01/2019

• HCBS January 2019 HCBS for Adults w/ SMDI Fee Schedule - Revised

04/01/2019 04/11/2019 01/01/2019

• Newsletters May 2019 Claim Jumper 04/12/2019 04/12/2019 05/01/2019

• ASC ASC Manual – Revised 04/12/2019 04/12/2019 04/11/2019





Item

Date Approved Date



2019 Presumptive Eligibility Income Calculator 04/01/2019 04/01/2019 01/01/2019

• Proposed Fee schedules

July 2019 Proposed HMK Dental Codes 03/29/2019 04/01/2019 07/01/2019

• DME • Physicians • Mid-Levels

Provider Notice DME Criteria for Home Ventilators

03/29/2019 04/01/2019 04/01/2019

• Home Dialysis Fee Schedule April 2019 Home Dialysis Fee Schedule

04/01/2019 04/01/2019 04/01/2019

• Pharmacy DUR DURB Minutes March 28, 2019 04/01/2019 04/01/2019 03/28/2019

• Laboratory Services

Fee Schedule – Revised Laboratory Services January 2019

04/02/2019 04/02/2019 01/01/2019

• Physician Fee Schedule – Revised Physician January 2019

04/02/2019 04/02/2019 01/01/2019

• Psychiatrist Fee Schedule – Revised Psychiatrist January 2019

04/02/2019 04/02/2019 01/01/2019

• Mid-Levels Fee Schedule – Revised Mid-Level Services January 2019

04/02/2019 04/02/2019 01/01/2019

• Podiatry Fee Schedule – Revised Podiatry January 2019

04/02/2019 04/02/2019 01/01/2019

• IDTF Fee Schedule – Revised IDTF January 2019

04/02/2019 04/02/2019 01/01/2019


Provider Notice New 2019 Psychological Testing Codes for Schools

04/03/2019 04/03/2019 04/01/2019

• All Providers Provider Notice Chronic Care Management Services – revised

04/04/2019 04/04/2019 03/26/2019

• Site Index • Hospital Inpatient • Hospital Outpatient • Podiatrist • ASC • Family Planning • Pharmacy • Optometric • Ambulance • Physicians • Laboratory Services • Mid-Levels • Eyeglasses • Dialysis Clinic • Psychiatrist • Clinical Pharmacist • Mobile Imaging • Licensed Direct Entry

Midwife

Quarterly Rebateable Labelers – April 2019 04/05/2019 04/05/2019 04/05/2019




March 29, 2019 Page/Provider

Item

Date Approved Date


• Family Planning Clinics

• Hospital Inpatient • Hospital

Outpatient • CAH • ASC • FQHC • RHC • IHS • Mid-Levels • Pharmacy • Physician • Public Health

Clinic

Provider Notice Montana Plan First – Change to Covered Procedures and service Codes

03/25/2019 03/25/2019 03/25/2019

• All Providers Provider Notice Chronic Care Management Services

03/26/2019 03/26/2019 03/26/2019




March 22 , 2019 Page/Provider

Item

Date Approved Date


• Pharmacy DUR DUR Agenda April 17, 2019 03/18/2019 03/18/2019 04/17/2019

• Pharmacy DUR Xeljanz® Executive Summary 03/18/2019 03/18/2019 04/17/2019

• Hospital Outpatient

• CAS • IDTF • Physician • Mid-Levels

Provider Notice Systematic Approval Diagnosis for MRI of the Head and CT of the Brain Updated (Revised)

03/18/2019 03/18/2019 03/18/2019

• Enrollment • Forms

EFT/ERA Form (Revised) 03/19/2019 03/19/2019 03/19/2019

• Hospital Inpatient • Hospital

Outpatient • CAH • ASC • DME • Private Duty

Nursing • Mid-Levels • Home Health

Agencies • Ambulance

Provider Notice Prior Authorization Qualitrac Portal

03/20/2019 03/20/2019 03/19/2019

• Passport Primary Care Case Management Agreement Form

03/20/2019 03/20/2019 03/20/2019

• Physicians Fee Schedule Physician January 2019 Revised

03/21/2019 03/21/2019 01/01/2019

• Mid-Levels Fee Schedule Mid-Level January 2019 Revised

03/21/2019 03/21/2019 01/01/2019

• Laboratory Services

Fee Schedule Laboratory Services January 2019 Revised

03/21/2019 03/21/2019 01/01/2019

• Training Dental WebEx Power Point 03/21/2019 03/21/2019 03/21/2019





Item

Date Approved Date


• Prior Authorization

Physician Administered Drug Pane Kymriah® Criteria

03/12/2019 03/12/2019 03/11/2019


Physician Administered Drug Pane Yescarta® Criteria

03/12/2019 03/12/2019 03/11/2019

• Newsletters April 2019 Claim Jumper 03/15/2019 03/15/2019 04/01/2019





Item

Date Approved Date



School-Based Services Fee Schedule And Cover Sheet January 2019

03/04/2019 03/01/2019 01/01/2019

• Contact Us All Contact Information Updated as received from the Department

03/04/2019 03/04/2019 03/04/2019

• Pharmacy DUR February 27, 2019 Pharmacy DUR Meeting Minutes

03/05/2019 03/05/2019 02/27/2019


• CAS • IDTF • Physician • Mid-Levels

Provider Notice Systematic Approval Diagnosis for MRI of the Head and CT of the Brain Updated

03/07/2019 03/07/2019 03/07/2019





Item

Date Approved Date


• Forms HHS 687 Consent for Sterilization Form Revised

02/22/2019 02/25/2019 02/22/2019

• FQHC • RHC

FQHC/RHC Manual Revised 02/25/2019 02/25/2019 02/22/2019

• Newsletters March 2019 Claim Jumper 02/25/2019 02/25/2019 03/01/2019


• FQHC • RHC

Billing Multiple Same-Day Visits on a UB-04 or 837I and Condition Code G0

02/27/2019 02/27/2019 02/19/2019




February 22, 2019 Page/Provider

Item

Date Approved Date


• Dentists • Denturists

Provider Notice Deleted Dental Codes D1515 and D9940

02/19/2019 02/19/2019 02/19/2019

• Hospital Inpatient Fee Schedule APR-DRG July 2019 Fee Schedule Revised

02/19/2019 02/19/2019 07/01/2018

• Pharmacy DUR DURB Agenda February 27, 2019 02/19/2019 02/20/2019 02/27/2019

• Inpatient Hospital • Outpatient

Hospital

Provider Notice Reimbursement Rate Change

02/20/2019 02/20/2019 02/19/2019

• Inpatient Hospital • Outpatient

Hospital • CAS • FQHC • RHC

Provider Notice Telehealth Originating Site Facility Fee

02/20/2019 02/20/2019 02/19/2019

• Training • Home • WebEx

SURS Update Training added to WebEx list for April 18, 2019

02/20/2019 02/20/2019 04/18/2019

• Training • Home • WebEx

TPL Update Training added to WebEx list for May 16, 2019

02/21/2019 02/21/0219 05/16/2019

• Dentists Provider Notice Orthodontia Prior Authorization Procedure Change

02/21/2019 02/21/2019 02/21/2019

• IHS Fee Schedule HIS January 2019 Revised

02/21/2019 02/212019 01/01/2019

• FQHC • RHC

Provider Notice Dental Hygienist and Dental Hygienist with Limited Access Permit (LAP)

02/21/2019 02/21/2019 02/21/2019

• Passport Amendment to Passport and Team Care Agreement for Private Group Practices Form Revised

02/22/2019 02/22/2019 02/22/2019





Item

Date Approved Date


• IHS January 2019 IHS Fee Schedule 02/14/2019 02/14/2019 01/01/2019

• Forms • IHS

T-HIP Member Opt-In Form Revised 02/14/2019 02/14/2019 02/14/2019

• Forms • IHS

T-HIP Provider Referral Form Revised 02/14/2019 02/14/2019 02/14/2019

• FQHC • RHC • IHS • Mid-Levels • Physicians • Public Health

Clinics

Provider Notice DOT Medical Examination

02/15/2019 02/15/2019 02/14/2019

• Pharmacy DUR PDL DUR Agenda March 27, 2019 02/15/2019 02/15/2019 03/27/2019


• CAS • IDTF • Physicians • Mid-Levels

Provider Notice Systematic Approval Diagnosis for MRI of the Head and CT of the Brain

02/15/2019 02/15/2019 02/15/2019


• CAS • IDTF • Physicians • Mid-Levels

Provider Notice Claims Processing for CT of the Brain and MRI of the Head

02/15/2019 02/15/2019 02/15/2019





Item

Date Approved Date


• Forms MA-3 – Revised 02/5/2019 02/05/2019 02/05/2019

• Hospital Inpatient Fee Schedule & Coversheet January 2019 Opps

02/06/2019 02/07/2019 01/01/2019

• Hospital Inpatient Fee Schedule & Coversheet January 2019 APC

02/06/2019 02/07/2019 01/01/2019

• WebEx Agenda for February 21, 2019 CMBH WebEx 02/08/2019 02/08/2019 02/21/2019





Item

Date Approved Date


• Home New IVR Announcement 01/25/2019 01/28/2019 01/28/2019


Dialysis Clinic Proposed Fee Schedule April 2019

01/29/2019 01/29/2019 01/29/2019

• Physicians • Mid-Levels

Provider Notice Kyleena®, Mirena®, and Skyla® Acquisition Costs

01/31/2019 01/31/2019 01/31/2019

• Forms MA-3 Form Revised 02/01/2019 02/01/2019 02/01/2019




January 25, 2019

Page/Provider

Item

Date Approved Date


• Direct Entry Midwife

Fee Schedule & Coversheet January 2019 Direct Entry Midwife

01/22/2019 01/22/2019 01/01/2019

• Mobile Imaging Fee Schedule & Coversheet January 2019 Mobile Imaging

01/22/2019 01/22/2019 01/01/2019

• IDTF Fee Schedule & Coversheet January 2019 IDTF

01/22/2019 01/22/2019 01/01/2019

• Podiatry Fee Schedule & Coversheet January 2019 Podiatry

01/22/2019 01/22/2019 01/01/2019

• Public Health Fee Schedule & Coversheet January 2019 Public Health

01/22/2019 01/22/2019 01/01/2019

• ASC Fee Schedule & Coversheet January 2019 ASC

01/22/2019 01/22/2019 01/01/2019

• Physicians Fee Schedule January 2019 Physician Revised

01/22/2019 01/22/2019 01/01/2019

• Mid-Levels Fee Schedule January 2019 Mid-Level Revised

01/22/2019 01/22/2019 01/01/2019


Presumptive Eligibility New Training Dates Added

01/22/2019 01/22/2019 01/01/2019







• Therapeutic Foster Care

Provider Notice New Psychological Testing Rates

01/23/2019 01/23/2019 01/23/2019

• Passport Passport Manual – Revised 01/23/2019 01/23/2019 01/18/2019

• Passport Passport Caseload Capacity Amendment 01/23/2019 01/23/2019 01/22/2019

• Passport Passport Provider Agreement 01/23/2019 01/23/2019 05/30/2018

• Passport Passport Referral Form 01/23/2019 01/23/2019 01/22/2019

• Passport Passport Member Change Form 01/23/2019 01/23/2019 01/22/2019

• Passport Requirements for Passport Disenrollment Letter 01/23/2019 01/23/2019 01/22/2019

• Passport What Is Passport 01/23/2019 01/23/2019 01/22/2019

• Forms • Prior

Authorization

Sublocade™ Prior Authorization Criteria and Form Revised

01/23/2019 01/23/2019 01/22/2019

• Site Index • Pharmacy

PDL – Revised 01/24/2019 01/24/2019 01/24/2019 01/24/2019




January 18, 2019 Page/Provider

Item

Date Approved Date



• Forms

Sublocade® Criteria Revised 01/15/2019 01/15/2019 01/15/2019

• Physicians • Mid-Levels • Hospital

Outpatient

Provider Notice Sublocade® (Injectable Extended Release Buprenorphine)

01/15/2019 01/15/2019 01/15/2019

• Laboratory Services Hospital Outpatient

Fee Schedule & Coversheet Laboratory Services January 2019

01/15/2019 01/15/2019 01/01/2019

• Mid-Levels Fee Schedule & Coversheet Mid-Levels January 2019

01/15/2019 01/15/2019 01/01/2019

• Physicians Fee Schedule & Coversheet Physicians January 2019

01/15/2019 01/15/2019 01/01/2019

• Optometric Fee Schedule & Coversheet Optometric January 2019

01/16/2019 01/16/2019 01/01/2019

• Optician Fee Schedule & Coversheet Optician January 2019

01/16/2019 01/16/2019 01/01/2019

• Nutrition EPSDT Fee Schedule & Coversheet Nutrition EPSDT January 2019

01/16/2019 01/16/2019 01/01/2019







• Therapeutic Foster Care

Provider Notice New Psychological Testing Rates

01/16/2019 01/16/2019 01/16/2019

• Newsletters February 2019 Claim Jumper 01/17/2019 01/17/2019 02/01/2019

• DME Fee Schedule & Coversheet DME January 2019

01/17/2019 01/17/2019 01/01/2019

• Physicians • Mid-Levels • Hospital

Outpatient • FQHC • RHC

Provider Notice Physician Administered Drug Update

01/17/2019 01/17/2019 01/15/2019


Physician Administered Drugs Pane CINQUAIR™ Criteria

01/17/2019 01/17/2019 01/17/2019


Physician Administered Drugs Pane Xolair™ Criteria

01/17/2019 01/17/2019 01/17/2019




Page/Provider

Item

Date Approved Date



Physician Administered Drugs Pane Fasenra™ Criteria

01/17/2019 01/17/2019 01/17/2019


Physician Administered Drugs Pane Nucala™ Criteria

01/17/2019 01/17/2019 01/17/2019

• Hearing Aid Fee Schedule and Coversheet Hearing Aid January 2019

01/17/2019 01/17/2019 01/01/2019

• Psychiatrist Fee Schedule and Coversheet Psychiatrist January 2019

01/17/2019 01/17/2019 01/01/2019




January 11, 2019

Page/Provider

Item

Date Approved Date


• Pharmacy DUR December 12, 2019 DUR Meeting Minutes 01/04/2019 01/07/2019 12/12/2018

• Training • Home Page • WebEx

CMBH WebEx Registration opened for February 21, 2019

01/07/2019 01/07/2019 02/21/2019

• Enrollment Paper Enrollment – Revised with new DDP Provider Type

01/06/2019 01/07/2019 01/01/2019

• Hospital Inpatient APR-DRG Revised July 2018 01/07/2019 01/07/2019 07/01/2018

• Hospital Inpatient APR-DRG Revised January 2019 01/10/2019 01/10/2019 01/01/2019

• Hospice Fee Schedule Hospice Compliant October 2018

01/09/2019 01/09/2019 10/01/2018

• Hospice Fee Schedule Hospice Non-Compliant October 2018

01/09/2019 01/09/2019 10/01/2018




January 4, 2019 Page/Provider

Item

Date Approved Date


• Developmental Disabilities

Provider Notice New Developmental Disabilities Program Type

12/28/2018 12/31/2018 12/31/2018

• Hospital Inpatient January 2019 APR-DRG Fee Schedule 01/03/2019 01/03/2019 01/01/2019

• Site Index • Hospital Inpatient • Hospital Outpatient • Podiatrist • ASC • Family Planning • Pharmacy • Optometric • Ambulance • Physicians • Laboratory Services • Mid-Levels • Eyeglasses • Dialysis Clinic • Psychiatrist • Clinical Pharmacist • Mobile Imaging • Licensed Direct

Entry Midwife

Quarterly Rebateable Labelers – January 2019

01/04/2019 01/04/2019 01/04/2019







Provider Notice New Psychological Testing Codes

01/04/2019 01/04/2019 01/04/2019







Provider Notice Severe Emotional Disturbance (SED) Incorrect ICD-10 Code

01/04/2019 01/04/2019 01/03/2019

• Psychologist Provider Notice Outpatient Psychotherapy Limits

01/04/2019 01/04/2019 01/03/2019




Page/Provider

Item

Date Approved Date


• PRTF • Social Worker • School-Based





