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  • A-Z Index
  1. Addictive and Mental Disorders
  2. Forms Applications
  3. Forms and Applications

Addictive & Mental Disorders Division

Forms and Applications

Medicaid Enrollment Application form for WASP and MHSP
.
Clinical Eligibility Form for WASP and MHSP
.
Applicant Checklist for WASP and MHSP
.
72-Hr Crisis Stabilization Form
.
Crisis Intervention and Response Form
.
  • Clinical Prior Authorization Form
  • Continued Stay Form
  • Serious Disabling Mental Illness (SDMI) and Level of Impairment Worksheet
  • Daily Limit Request
  • Addictive and Mental Disorders Division Data Corrections Request
  • Substance Use Disorder (SUD) Prior Authorization Request Form for Residential and Inpatient Services
  • Substance Use Disorder (SUD) Continued Stay Request Form for Residential and Inpatient Services

Behavioral Health and Developmental Disabilities Division
formerly known as  Addictive & Mental Disorders

Contact BHDDD

Staff Contact List

Healing and Ending Addiction through Recovery and Treatment (HEART) Waiver Submission

The Montana Department of Health and Human Services submitted an application to the Centers for Medicare and Medicaid Services on October 1, 2021, to expand available behavioral health treatment for Medicaid members. This application for an 1115 demonstration seeks federal authority to pay for expanded inpatient and residential treatment options as well as additional community based treatment services. For more information, please contact Isaac Coy, Treatment Bureau Chief, icoy@mt.gov, (406) 444-7922 or go to  Medicaid HEART Waiver.

Suicide Prevention

Substance Abuse Prevention Program

Crisis Systems Information and Resources

Utilization Management and Review Training

Documentation Training

  • BHDD Medicaid Services Provider Manual Effective October 1, 2022
  • BHDD Non-Medicaid Services Provider Manual Effective October 1, 2022
  • AMDD Non-Medicaid Services Provider Manual for SUD and Adult Mental Health, Effective July 1, 2020
  • AMDD Medicaid Services Provider Manual for SUD and Adult Mental Health, Effective April 1, 2021

Services

  • Fee Schedules
  • Adult Mental Health Services
  • Substance Use Disorder Services
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Find Treatment

  • Treatment Services Locator

  • Map of Montana Substance Use Disorder Providers
  • Montana Mental Health Centers
  • State Approved Substance Abuse Treatment Providers
  • NAMI-MT County Resource Guide
  • SAMHSA's National HelpLine

More Information

  • Provider Information and Fee Schedules
  • Substance Use in Montana
  • For a copy of the SYNAR report, please contact Jackie Jandt at 444-9656
  • For Public Comment on the Mental Health and/or Substance Abuse Block Grant plan, please contact the Program Officer at (406) 444-9657.
  • If you are interested in receiving notifications regarding rule making send an email to cdallas2@mt.gov and request to be added to the interested parties for for rules email list
  • Community Mental Health
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