Provider Connection

Facility fee schedule delayed!

Public comments delay implementation

A public hearing was held on May 16, 2008 concerning the proposed amendments and changes to the workers’ compensation medical fee schedule for facilities. Public comments voicing concerns about implementation timelines and methodology have led the department of labor & industry (DOLI) to delay implementation pending another hearing. Please see the Department of Labor & Industry’s website for further information at http://erd.dli.mt.gov/wcregs/medreg.asp.

Montana non-facility fee schedule (MNFS)

There are two different levels (facility and non-facility) of practice expense RVUs for each procedure code depending on the site-of-service:

  • Non-facility column: the allowed fee paid for each service when that service is provided in non-facility settings, such as the physician’s office, patient’s home or other non-facility setting. The higher non-facility practice expense RVUs are used to calculate payments for services performed in a physician’s office and for services furnished to a patient in the patient’s home, or facility or institution other than a Hospital skilled nursing facility (SNF)or ambulatory surgical center (ASC). The physician typically bears the cost of resources (labor, medical supplies and equipment).
  • Facility Column: the medical provider s allowed fee for each service when that service or procedure is provided in a hospital, ambulatory surgery center (ASC), skilled nursing facility(SNF)or other licensed medical facility setting

The lower facility practice expense RVUs are used to calculate payments for physicians’ services provided in a hospital, SNF or ASC facilities. The cost (resources) for providing the services is typically borne by the hospital  SNF or ASC.

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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)