INDEXES

DATE REVISED

001

Index

04/01/07

002

Alpha Subject Index

04/01/07

400

ELIGIBILITY FOR SERVICES

401

H & C Based Services Eligibility Requirements

01/01/06

402

Care Categories

01/01/06

403

Prior Authorization by the CSB

04/01/07

404

Termination of Services

04/01/07

405

Referrals for Services

04/01/07

406

Waiting List Criteria

01/01/06

407

Medically Needy Billing Procedures

12/01/05

408

Residency Requirements

01/01/06

409

Out-of-State Services

03/01/05

410

Bed-Hold Days

04/01/07

411

Developmentally Disabled

03/01/05

499-1

Provider Information Memo (DPHHS-HCS-454)

03/01/05

500

PREADMISSION SCREENING

501

Screening Requirements

03/01/05

502

Screening Referral Procedures

01/01/06

503

Level of Care Reevaluations

03/01/05

504

Reserved

504

ScAN

599-1

Screening Determination (DPHHS-SLTC-61)

04/01/07

600

ADMINISTRATIVE REQUIREMENTS

601

Provider Eligibility

03/01/05

602

Provider Responsibilities

03/01/05

603

Provider Enrollment

01/01/06

604

Payment Requirements

01/01/06

604-1

Payment to Legally Responsible Individuals

605

Payment Processing

04/01/07

606

Reimbursement Methodology

03/01/05

607

Licensure Requirements

03/01/05

608

Quality Assurance Process

04/01/07

699-1

Provider Requirements

03/01/05

699-2

CMS 1500 Claim Form IN PDF FORMAT

04/01/07

699-3

HCBS Procedure Codes & Rates

04/01/07

699-4

Medicaid Nursing Facility Reimbursement Rates

699-5

Prior Authorization Form

700

SERVICES

701

Covered Services

03/01/05

702

Service Limitations & Exclusions

01/01/06

703

Adult Day Health

03/01/05

704

Adult Residential Care

04/01/07

705

Behavioral Programming

03/01/05

706

Case Management

03/01/05

707

Chemical Dependency Counseling

 03/01/05

708

Cognitive Rehabilitation

 03/01/05

709

Community Residential Rehabilitation

03/01/05

710

Comprehensive Day Treatment

03/01/05

711

Day Habilitation

04/01/07

712

Dietitian/Nutritionist

03/01/05

713

Environmental Accessibility Adaptations

01/01/06

713B

Consultant

03/01/05

714

Habilitation

01/01/06

715

Homemaker

03/01/05

716

Nutrition

03/01/05

717

Occupational Therapy

03/01/05

718

Personal Assistance

04/01/07

719

Personal Emergency Response System

03/01/05

720

Physical Therapy

03/01/05

721

Prevocational Training

04/01/07

722

Private Duty Nursing

01/01/06

723

Psychosocial Consultation

01/01/06

724

Registered Nurse Supervision

03/01/05

725

Respiratory Therapy

03/01/05

726

Respite Care

03/01/05

727

Special Child Care for Medically Fragile Children

01/01/06

728

Specialized Medical Equipment & Supplies

03/01/05

729

Specially Trained Attendants

03/01/05

730

Speech Therapy and Audiology

03/01/05

731

Supported Employment

03/01/05

732

Supported Living

04/01/07

733

Transportation

03/01/05

734

Consumer/Family Intensive Support Service

01/01/06

735

Family Training and Support

04/01/07

799-1

Home & Community Based Services

03/01/05

799-1

  Administrative Rules of Montana 37.40.1401 - 37.40.1488  

799-2

PAS Consumer Referral/Overview (DPHHS-SLTC-154)

01/01/06

799-3

Service Animals - Case Management Team’s Role

03/01/05

799-4

Service Animals – Consumer’s Role

03/01/05

799-5

Directory of Assistive Technology Practitioners 

 03/01/05

799-6

Consumer Recycling Agreement

03/01/05

799-7

Field Memorandum FY95

01/01/06

800

CASE MANAGEMENT SYSTEM

801

Case Management Requirements

01/01/06

802

Case Management Team Requirements

03/01/05

803

Service Areas

03/01/05

804

Record Requirements

03/01/05

805

Budget Requirements

01/01/06

806

Reporting Requirements

03/01/05

807

Contract Termination & Transition

03/01/05

808

Transfer of Consumers or Change of

  Consumer’s Classification

01/01/06

809-1

Plan of Care: Development

01/01/05

809-2

Plan of Care: Components

01/01/06

809-3

Plan of Care: Requirements

03/01/05

809-4

Plan of Care: Costs

01/01/06

809-5

Plan of Care: Reevaluations

03/01/05

809-6

Plan of Care: Amendments

01/01/06

809-7

Plan of Care: Annual Updates

01/01/06

810

Consumer Advisory Councils

01/01/06

811

Year-End Money

01/01/06

899-1

Year-End Money Form

03/01/05

899-2

Reporting Requirements, Forms & Instructions

01/01/06

899-3

Reserved

03/01/05

899-4

HCBS Forms Requisition Page 2

01/01/06

899-5

Plan of Care Cost Limits

01/01/06

899-6

Entrance Into Medicaid & HCBS

  (DPHHS-SLTC-55) Instructions

03/01/05

(DPHHS-SLTC-85) Instructions

01/01/06

899-8

Level of Care Determination

  (DPHHS-SLTC-86) Instructions

01/01/06

899-9

Adult Residential Care Calculation Page 2

  (DPHHS-SLTC-132) Instructions

12/01/05

899-10

Plan of Care Cost Sheet

  (DPHHS-SLTC-134) Instructions

01/01/06

899-11

Plan of Care (DPHHS-SLTC-135)

Instructions

01/01/06

899-11B

Plan of Care Short Form

  (DPHHS-SLTC-135B) Instructions

01/01/06

899-12

Intake Sheet (DPHHS-SLTC-136)

Instructions

01/01/06

899-13

Discharge Sheet (DPHHS-SLTC-137)

  Instructions

01/01/06

899-14

Authorized Services for Incurment

  (DPHHS-SLTC-131) Instructions

01/01/06

899-15

Reevaluation Form (DPHHS-SLTC-139)

  Instructions

03/01/05

899-16

Amendment Form (DPHHS-SLTC-141)

  Instructions

01/01/06

899-17

Psychosocial Summary (DPHHS-SLTC-143)

  Instructions

03/01/05

899-18

Letter of Notification (DPHHS-SLTC-144)

  Instructions

01/01/06

899-19

Level I Screen (DPHHS-SLTC-145)

  Instructions

01/01/06

899-20

Waiting List Criteria Tool (DPHHS-SLTC-146)

  Instructions

04/01/07

899-21

Request for Prior Authorization CC3

  (DPHHS-SLTC-148) Instructions

01/01/06

899-22

Request for Prior Authorization

  (DPHHS-SLTC-149) Instructions

03/01/05

899-23

Service Animals - Provider Assurances

  (DPHHS-SLTC-142) Instructions

03/01/05

899-24

Service Animals - Stewardship Agreement

  (DPHHS-SLTC-142) Instructions

03/01/05

899-25

Waiting List Database Instructions

03/01/05

9900

APPENDIX

9901

Definitions

03/01/05

9902

Abbreviations/Acronyms/Initials  

03/01/05