Medical Regulations

UPDATE (April 1, 2015)

Effective April 1, 2015, the Montana Employment Relations Division has published proposed updates to the Montana medical fee schedules, including both the Professional Fee Schedule and the Facility Fee Schedule.

To view the fee schedules, please visit the related fee schedule page (see column at right).

Medical Regulations Unit

The Medical Regulations Unit is the primary liaison for the Department with providers, claims examiners and insurers who have questions, need assistance or require direction on all issues relating to the medical regulation of workers’ compensation claims, including medical fee schedules, utilization and treatment guidelines, and timely payments.  The unit maintains and updates medical fee schedules for providers and payers and ensures access through a web based delivery system.  The unit has a Medical Director, who is responsible for the maintenance, annual updates, distribution and training of the Montana Utilization and Treatment Guidelines. The Medical Director also performs independent medical reviews for denied services. The unit certifies injured workers for the Subsequent Injury Fund (SIF), applies the fee schedules to medical expenses, makes decisions on requested settlements as needed, manages the SIF fund balance, and authorizes payments for eligible SIF expenses.

Guidance

Periodically the Department may post clarifications on the medical fee schedules.  These can be located once the user has accepted the website usage permissions and logged into the site.  See the Montana Facility Fee Schedule for the following clarification:

April 1, 2015: Facility Fee Schedule (outpatient) J1 Status Indicator
                     Professional Fee Schedule Modifier 59

Contact Information

For further information, please email or phone us at (406) 444-6604.

Medical Regulations
Work Comp Claims Assistance Bureau
PO Box 8011
Helena, MT 59604-8011

Dr. Carla Huitt, MD, MPH
Medical Director
(406) 444-6543
chuitt@mt.gov

Maralyn Lytle
(406) 444-6604
mlytle@mt.gov