Rural Health Clinic
General Information for Providers
Medicaid manual with general information for all provider types.
Rural Health Clinic
This manual has information specific to your provider type.
Current Edition
Previous Edition
- Federally Qualified Health Center and Rural Health Clinic Provider Manual Effective November 1, 2021
Prescription Drug Program, Prior Authorization
Prior authorization requirements and procedures are covered in this chapter.
Passport to Health
Everything a provider needs to know to become a successful Passport provider.
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
For prescription medication notices, see the Pharmacy page/
2025
01/15/2025 Montana Healthcare Programs Support Services Holiday Closures
01/06/2025 Montana Prescription Drug Registry Survey for Federal Fiscal Year 2024
2024
12/19/2024 Montana Medicaid Enrollment Requirements for In-Training Mental Health Professionals
12/19/2024 IRS Tax Identification Letter Required for Pay-To Providers
12/04/2024 Change in the Double Electric Breast Pump Provider
11/04/2024 Paper Claim Denials
10/30/2024 Beyfortus and Synagis Coverage for RSV Prophylaxis
10/18/2024 Electronic Adjustments Void or Void/Replace
10/15/2024 Revalidation Requirements Deadline
10/11/2024 COVID-19 Vaccine Codes Removed from Plan First Covered Codes List
09/18/2024 Vaccines for Children Code Update
08/09/2024 Vaccines for Children Code Update
07/26/2024 Peer Support Services for Dual Eligible Members
07/22/2024 Qualifying Visits for Prospective Payment System Reimbursement
06/28/2024 January 1, 2024 and July 1, 2024 Fee Schedule Updates
06/18/2024 DEA Number Required for Prescribers REVISED
06/11/2024 Health Resources Division Claims Appeal Process
05/21/2024 DEA Number Required for Prescribers
05/10/2024 Peer Support Services for Dual Eligible Members Refer to Updated Notice 07/26/2024
05/08/2024 Vaccines for Children Code Update
05/01/2024 Paperwork Attachments Submission Timing for Electronic Claims
05/01/2024 Eligibility Inquiry and Service Type Code in the MATH Portal
04/30/2024 Diabetes Prevention Program Information
04/19/2024 Changes Regarding Opioid Prior Authorization and Medication for Opioid Use Disorder
04/05/2024 Written Orders for Physical, Occupational, and Speech Therapy
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
02/14/2024 How to Obtain a Double Electric Breast Pump, HCPCS E0603
02/14/2024 Medicaid 12-Month Postpartum Continuous Eligibility Coverage
01/29/2024 Vaccines for Children Code Update
01/23/2024 Montana Healthcare Programs Support Services Holiday Closure REVISED
01/08/2024 AMP Cap Removal and Medication Access
01/08/2024 Electronic Claim Adjustment Processing Change
2023
12/22/2023 Passport Provider Referral Number on Claims
12/19/2023 Montana Prescription Drug Registry Survey
12/12/2023 Individual Providers Enrolled as Sole Proprietors Due for Revalidation
11/08/2023 Prior Authorization Information
11/01/2023 Beyfortus and Synagis Coverage for RSV Prophylaxis
10/31/2023 Managed Care Referrals IHS, Tribal 638, and Urban Indian Organizations REVISED
10/24/2023 Medicare to Cover Approved LPC and LMFT Services
10/16/2023 Vaccines for Children Code Update
09/15/2023 Claims Payment Discrepancy Update
09/14/2023 Claims Payment Discrepancy Identified
09/08/2023 Medicaid Claims Payment Delayed
08/30/2023 Attestation Form Required for Qualifying Clinical Trials
08/18/2023 Case Management and Medication Assisted Treatment (MAT) Services
08/01/2023 Provider License Expiration Reminder Letters
07/06/2023 Provider Rate Increases
05/30/2023 Substance Use Disorder Billing Reminder REVISED
05/26/2023 Medicaid Reimbursement and Court Ordered Services REVISED
05/08/2023 Diabetes Prevention Program (DPP) Information 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
02/10/2023 837I Ancillary Charge Claim Rejections
01/04/2023 Montana Healthcare Programs Support Services Holiday Closures
2022
12/23/2022 Plan First Updated Code List Descriptions
11/09/2022 Prior Authorization Criteria for Synagis®
09/19/2022 Vaccines for Children (VFC) Code Update
09/19/2022 New Plan First Covered Code
09/01/2022 Sterilization Consent Form MA-38 to be Discontinued
08/05/2022 Bipartisan Budget Act of 2018 Cost Avoidance Statute Changes
06/17/2022 Plan First Updated Code List Descriptions
06/03/2022 Circumcision Prior Authorization Changes REISSUED
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
05/11/2022 Prior Authorization Qualitrac Portal REISSUED
05/11/2022 Dental Hygienist and Dental Hygienist with Limited Access Permit (LAP) REISSUED
05/11/2022 Peer Support Services REISSUED Refer to Updated Notice 07/26/2024
05/11/2022 FQHC and RHC Fee Schedule Reminder REISSUED
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
01/05/2022 Healthy Montana Kids (HMK) Vaccine Administration Codes
01/04/2022 Vaccines for Children (VFC) Code Update