Montana Medicaid Fee Schedule

Montana Healthcare Programs, published by the Montana Department of Public Health and Human Services (DPHHS). Schedules effective through 2026.

Montana publishes 13,686 Medicaid fee-for-service rates across 10 service categories. An established-patient office visit (99213) pays $124.79, a two-view chest X-ray (71046) $45.86 and a CPAP device (E0601) $866.90. Pooled across categories with a national Medicare comparator, Montana's published rates run a median 134.6% of the Medicare amount, ranking 3 of 49 jurisdictions with a comparable basis.

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These pages show common-procedure samples per category. The complete all-codes Montana schedules export as CSV with the Rates plan.

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Montana's published schedules by category

Codes on the current schedule, the newest effective date, the median published rate as a percentage of national Medicare where a comparator exists, and one recognizable procedure's rate per category. Open a category for its common-procedure table.

CategoryCodesEffectiveMedian % of MedicareExample ratePA required
Physician7,0012026143.1%$124.79 Office visit, established patient, low complexity (20-29 min) (99213)200
Lab & Imaging2,7112026100%$45.86 Chest X-ray, 2 views (71046)9
DME & Supplies1,8432026100%$866.90 Continuous positive airway pressure (cpap) device (E0601)190
Drugs8952026----32
Vision145202633.7%$200.67 Eye exam, new patient, comprehensive (92004)4
Behavioral Health262026130%$216.51 Psychotherapy, 60 minutes (90837)4
Anesthesia2752026------
Hearing462026--$1,060.45 Hearing aid, digital, binaural, bte (V5261)41
Transport182026--$158.36 Ambulance service, basic life support, non-emergency transport, (bls) (A0428)16
State-Specific Services7262026100%$31.85 Telehealth originating site facility fee (Q3014)66
DentalMontana's dental Medicaid rates live in the dental section, with their own per-state page.

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one.

Where Montana publishes its fee schedules

Publisher
Montana Department of Public Health and Human Services (DPHHS)
Program
Montana Healthcare Programs
Official source
https://medicaidprovider.mt.gov/
Last checked
Aug 21, 2026

ProviderSignal collects every category from the state's publication, standardizes the rows and labels each code in its own plain language. Rates are the published amounts; the state's page remains the legal source.

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These are common-procedure samples. The complete Montana schedules, every category and every code, export as CSV on the Rates plan.

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Frequently asked questions

Does Montana publish a Medicaid fee schedule?

Yes. Montana publishes 13,686 Medicaid fee-for-service procedure rates across 10 service categories, effective through 2026, all collected and normalized here with plain-language procedure names. Montana Department of Public Health and Human Services (DPHHS) publishes Montana's Medicaid fee schedules for Montana Healthcare Programs.

Who publishes Montana's Medicaid fee schedule?

Montana Department of Public Health and Human Services (DPHHS) publishes Montana's Medicaid fee schedules for Montana Healthcare Programs. The state's own fee-schedule page is https://medicaidprovider.mt.gov/. ProviderSignal collects every category from it, standardizes the rows and re-checks the source on a rolling cadence (last checked Aug 21, 2026).

What does Montana Medicaid pay for common services?

An established-patient office visit (99213) pays $124.79, a two-view chest X-ray (71046) $45.86 and a CPAP device (E0601) $866.90. Every figure is the state's published fee-for-service amount for the code's benchmark locality; managed-care plans can pay differently. The category pages list common procedures with plain-language names, and the complete all-codes schedules export as CSV on the Rates plan.

How do Montana's Medicaid rates compare with Medicare?

Pooled across categories with a national Medicare comparator, Montana's published rates run a median 134.6% of the Medicare amount, ranking 3 of 49 jurisdictions with a comparable basis.

What service categories does Montana publish?

Physician (7,001 codes), Lab & Imaging (2,711 codes), DME & Supplies (1,843 codes), Drugs (895 codes), Vision (145 codes), Behavioral Health (26 codes), Anesthesia (275 codes), Hearing (46 codes), Transport (18 codes), State-Specific Services (726 codes). Dental rates have their own section with per-state pages.

How current are these rates?

Rates come from Montana's currently published fee schedules, the newest effective 2026, and are re-collected on a rolling monthly cadence. This page updates automatically after each collection sweep.