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Provider Manuals

Name Description
Active Providers Moved to Provider Listings
Carrier codes Listing of Third Party Carriers and Carrier Codes
Chronic Care Diagnoses Catamount Health-Chronic Care wrap-around diagnosis codes.
Clinical Resources Billers, please follow this link to clinical guidelines and other clinical resources.
CMS 1500 08/05 Supplement Provider manual with billing instructions for the CMS1500 08/05 claim form.
Dental Fee Schedule Schedule of Dental Fees
Dental Supplement Provider Manual with billing instructions related to the dental claim
Diagnosis/Surgical Codes Mapping of new 2008 ICD-9 diagnosis and surgical procedure codes to current codes. This is to be used if hospitals did not purchase grouper software where the mapping is done automatically effective October 1, 2007.
DME Restrictions Current DME codes with each restriction, allowable modifier and unit limitation.
DRG Q&A Questions and Answers for providers pertaining to DRG payment methodology.
2007 E & M Rates Updated list of RBRVS rates.
EOB Codes X-walk Vermont Medicaid non-compliant EOB codes cross walked to HIPAA-compliant adjustment reason codes.
Fee Schedules Fee Schedule of CPT/HCPCS Codes.
Moved to Provider Listings Ladies First Active Providers List
OPPS Revenue code requiring HCPCS/CPT All active revenue codes marked with Yes require CPT/HCPCS coding. THE PREPARATION FOR THE IMPLEMENTATION OF OPPS PRICING HAS NOT CHANGED VERMONT MEDICAID POLICY REGARDING NON-COVERED SERVICES
PA Supplement The Prior Authorization Supplement contains billing and policy information. Please refer to the Fee Schedule for the procedure codes that require prior authorization.
Vermont Medicaid Pre-Procedure Request Form Pre-Procedure Request form. Pages 1 & 2 are mandatory and pages 3 & 4 are to be used when applicable.
OPPS Provider Bulletin for Outpatient Hospital Billers Important OPPS Provider Bulletin for Outpatient Hospital Billers
Moved to Provider Listings Provider List for Dartmouth Hitchcock house staff
Moved to Provider Listings Provider List for Fletcher Allen Health Care house staff
Provider Manual Base Provider Manual which contains info related to policy and eligibility
Relative Weights Vermont-based Relative Weights Effective January 1, 2008.
Transportation UNDER CONSTRUCTION - OVHA/EDS Provider Manual with information related to the Medicaid transportation service
UB 04 Provider manual with billing instructions for the UB04 claim form.
X12N guides Website where the HIPAA X12N Implementation Guides can be found and downloaded.
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