Click here for the statute and click here for the administrative rule.

The standard conversion factor and the Anesthesia conversion factor are located in the Instruction Set. Each Provider Category no longer utilizes its own separate conversion factor. Instead, there is now only one standard conversion factor used for all categories except Anesthesia. There is a separate conversion factor for Anesthesia.

Click here for the Nonfacility fee schedule Instruction Set.

The fee schedule should be applied to all workers’ compensation medical procedures and services provided on or after January 1, 2008.

Click here for prior fee schedules.

When billing the services listed below, the Montana unique code, MT001, must be used and a separate written report is required describing the services provided. The reimbursement rate for this code is 0.5 RVUs per 15 minutes. These requirements apply to the following services:

1. face-to-face conferences with payer representative(s) to update the status of a patient upon request of the payer;
2. a report associated with nonphysician conferences required by the payer; or
3. completion of a job description or job analysis form requested by the payer.

You may contact the Department for assistance with your dispute. Please email shapeterson@mt.gov or call us at (406) 444-7732. The law provides that you must first attempt to resolve your dispute through the Mediation process and if unsuccessful proceed to a contested case hearing.