Medicaid Provider Information

Provider Manuals

All Providers

• General Information for Providers - Medicaid and Other Medical Assistance Programs (April 2012)
  • Chapters updated include:
    • Provider Requirements
    • Billing Procedures
    • Certified Nurse Practitioners
    • Chiropractic Services
    • Coordinated Services Program (CSP)
    • Managed Care
    • Transportation Services

Behavioral Health Providers

• Ambulatory Behavioral Health Care for Adults (January 2005) (111kb pdf)
• Ambulatory Behavioral Health Care for Children and Adolescents (June 2006) (196kb pdf)

Dental Providers

• Dental Provider Manual (May 2010) (1.37 MB pdf) - multiple changes throughout the provider manual have occurred.

Durable Medical Equipment Providers

• Durable Medical Equipment Provider Manual -- currently under contruction, see updated policies below
  • Bath/Shower Chair or Tub Stool/Bench - effective 7/1/2011
  • External Infusion Pump - effective 6/15/2011
  • External Insulin Infusion Pump - effective 6/15/2011
  • Enteral Nutrition - effective 1/1/2012
  • Incontinent Garments - effective 1/1/2012
  • Breast Pump - effective 1/1/2012

Hospice Care Providers

• Hospice Care Services Manual (April 2005) (58kb pdf)

Nursing Facility Providers

• Nursing Facility Rate Manual (July 2011) (362kb pdf)
• RUG IV Classification Manual (April 2012)
• MDS 3.0 Submission Guildlines (December 2011)
• ND Nursing Facility Payment System Booklet (January 2012) - May be printed in booklet form. Choose under 'Page Scaling' in the Adobe print screen.
• Medicaid Payment Alert Form (April 2010) (15kb pdf)
• Dual Diagnosis Screening for Long Term Care Manual (February 2012) (1.3 Mb pdf)
• Dual Diagnosis Level 1 Screening Form (April 2011) (383kb pdf)
• Dual Diagnosis Level of Care/Continued Stay Review Form (July 2010) (214kb pdf)
  • Dual Diagnosis Level of Care/Contiued Stay Form Instructions (November 2009) (228kb pdf)
• Dual Diagnosis Nursing Facilities Tracking Form (99kb doc)

Optometric Providers

• Optometric and Eye Glass Services Manual (February 2011) (1.14Mb pdf)
• Vision Prior Authorization Form (February 2011) (301kb pdf)

Pharmacy Providers

• Pharmacy Provider Manual (April 2010) (632 kb pdf)

Under 21 Psychiatric Providers

• Dual Diagnosis Screening for Psychiatric Services Manual (March 2009) (1.57Mb pdf)
• Dual Diagnosis Residential Review Form (April 2011) (323kb pdf)
• Dual Diagnosis Acute Review Form (April 2011) (332kb pdf)
• Dual Diagnosis Discharge Notification/Tracking Form (160kb pdf)
• IMD Admission/Discharge Alert

 

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