Provider Connection

COVID-19 Coverage

With the COVID-19 pandemic being prevalent at this time, Montana State Fund (MSF) has released  recommendations for clinics who are providing telephonic or virtual services to our injured workers during this crisis:

We thank you for being flexible during this time and if you have any questions, please let us know.  We want to thank providers for continuing to see our injured workers in this time of uncertainty and wish everyone safety and wellness!  Please see below for approved telemedicine services for MSF:

Note:  Please use POS 02 in Box 24B of the CMS 1500 form to indicate that the services provided have been via a telephonic/video type method.  The GT modifier may also be applied for audio/video telecommunications.  For timed codes, please document total time spent in the record.

99201 – 99215 Evaluation and Management visits that normally require face to face time will be allowed as audio/video visits.  Documentation does need to support the services billed.

Psychotherapy services

90832:  30 minutes
90834:  45 minutes
90837:  60 minutes

Psychological Evaluations will need to be authorized prior to service by calling Michele Fairclough, Director of Medical Services, at 406-495-5362.

Online Digital Evaluation and Management service, for an established patient, for up to 7 days, cumulative, for up to seven days:

99421:  5-10 minutes
99422:  11-20 minutes
99423:  21 or more minutes


Telephone Evaluation and Management (E/M) services by a physician or other qualified health care professional who may report E/M services provided to an established patient:

99441:  5-10 minutes
99442:  11-20 minutes
99443:  21-30 minutes

Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient or episode of care initiated by an established patient:

98966:  5-10 minutes
98967:  11-20 minutes
98968:  21-30 minutes

Qualified non-physician health care professional online digital (non-face to face) E/M service utilizing internet resources for an established patient, for up to 7 days, cumulative time during those 7 days:

98970:  5-10 minutes98971:  11-20 minutes
98972:  21 or more minutes

Physical/Occupational Therapy can use the above codes as applicable; also, MSF will allow the following re-evaluation codes:

97164 – Physical Therapy Re-evaluation
97168 – Occupational Therapy Re-evaluation

The following Physical or Occupational Therapy initial evaluations will need to be pre-authorized by calling Michele Fairclough at the number listed at the end of this publication:

97161
97162
97163
97165
97166
97167

For physical/occupational therapies, MSF will allow the following codes for a total of 2 units (30 minutes) for the management of home exercise:

97110
97530
97535

We understand that there may be questions regarding different circumstances as we go along.  Please call Michele Fairclough, Director of Medical Services, at 406-495-5362 or Kym Vonada at 406-495-5389 and we will work toward getting these issues resolved.

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Bill Status – 1-866-274-7464

Main Phone Number 406-495-5000 or 800-332-6102

Main Fax  406-495-5020

Medical Team – 406-495-5011

Submit your Claims and/or Correspondence To
Montana State Fund
PO Box 4759
Helena, MT  59604

RMS (Bill Status)
Phone  866-274-7464
Email customer.care@risingms.com

For questions about information in this bulletin, call 800-332-6102 and ask for a member of the Medical Team.
For questions about Advanced Nurse Review contact Kym Vonada at 406-495-5389.


Medical Team

Michele Fairclough
Medical Team Leader
406-495-5362

Justin Kennedy
Nurse Manager
406-495-5417

Shannon Hadley
Provider Relations Specialist
406-495-5245

Kym Vonada
Medical Auditor
406-495-5389

Annalyn Stewart
Medical Payment Auditor
406-495-5367

Sheryl Semans
Pharmacy Liaison
406-495-5010

Susan Bomar
Medical Payment Auditor
406-495-5271

Cindy Gallus
Medical Customer Service Liaison
406-495-5189

Sherri Sprenger
Medical Customer Service Liaison
406-495-5420

Shannon Mergenthaler
Medical Customer Service Liaison
406-495-5185

Maggie Pentecost
Medical Customer Service Liaison
406-495-5322

Jamie Statton
Medical Customer Service Liaison
406-495-5386

Website Information

Montana State Fund montanastatefund.com

Department of LaborDepartment of Labor and Industry (DLI) website.
The website includes the Facility and Non-Facility Fee Schedule information as well as the Administrative Rules of Montana (ARM) and the instruction set for the Non-Facility Fee Schedule. Historical fee schedule information can also be found on this website.

If you have questions regarding the fee schedules call 406-444-6530 and someone will direct you to a DLI representative. For NPI information click here National Plan and Provider Enumeration System (NPPES)