Department of Labor & Industry - Employment Relations

Additional Links

• 2010 Montana Facility Fee Schedule
• Unit One - Understanding Montana Worker's Compensation (WC) Facility Fee Schedule
•  Unit Two - Understanding the Workers' Compensation (WC) Facility Fee Schedule (Using the UB04)
• Help Us Identify User Training Needs
• Facility Fee Schedule Administrative Rules of Montana
• Montana Nonfacility Fee Schedule
• Nonfacility Fee Schedule Administrative Rules of Montana
  
• Historical Fee Schedule Conversion Factors for 2003-2007
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• Historical Reference to Workers' Compensation Hospital Discount Rates (Word)
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• Historical Reference to Workers' Compensation Hospital Discount Rates (PDF)
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• 2009 Hospital Rate Change Reports
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• 2009 Domiciliary Care Referral (Form 301)
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• Managed Care Organizations
• Billing Address Information for Medical Providers

Subsequent Injury Fund Application (Word)

Subsequent Injury Fund Application (PDF)

Medical Regulations

39-71-704 MCA

The Department develops, implements, and monitors medical cost-containment strategies, including fee schedules to reimburse Facility and NonFacility providers. The Facility Fee Schedule has an effective date of December 1, 2008. The NonFacility Fee Schedule was effective January 1, 2008. Training for the new Facility Fee Schedule can be found under "Additional Links" in the left margin, under the heading, "Understanding Workers' Compensation (WC) Facility Fee Schedule". The NonFacility Fee Schedule has an instruction set on its web page. The Facility Fee Schedule applies to Montana facilities, namely Acute Care Hospitals (ACHs) and Ambulatory Surgery Centers (ASCs), for WC services provided on or after December 1, 2008.

In 2007, the Montana legislature passed legislation directing the Department to establish a “Resource-Based Relative Value Scale (RBRVS) fee schedule for NonFacility medical services provided to injured workers. This fee schedule applies to all NonFacility procedures and services provided on or after January 1, 2008.

No Base Rate Adjustments for January 1, 2010

The base rates for hospital inpatient, outpatient and ambulatory surgery centers will not be adjusted until the Department has an opportunity to review payment data received from carriers and medical providers. Providers were given the opportunity to report to the Department quarterly, so the impact of new DRG and APC fee schedules could have been evaluated earlier. No providers submitted any information during this voluntary submission period.

Hospitals and ambulatory surgery centers are required by section 24.29.1432(8) to submit payment information on an annual basis. The rule states “Hospitals and ASCs must, on an annual basis, submit to the department data reporting Medicare, Medicaid, commercial, unrecovered, and workers' compensation claims reimbursement in a standard form supplied by the department.”  The format for these reports was sent out previously and a reminder notice will be going out soon.

Unproven Medical Procedures and Treatments HIPAA &The Release of Workers' Compensation Information Travel Expense Reimbursement Travel Expense Reinbursement Rule Meals Mileage Lodging

For further information, please email or phone us at (406)444-7732.

Medical Regulations
Workers' Compensation Regulation Bureau
Employment Relations Division
PO Box 8011
Helena, MT 59604-8011