Manuals

Rules

AHS Health Care Administrative Rules.
The Agency of Human Services is undertaking a comprehensive revision of Medicaid rules across the Agency of Human Services and its Departments. The Medicaid Covered Services Rules above will be amended and adopted under the title of Health Care Administrative Rules (HCAR). This is a multi-year process, and during this transition phase, some Medicaid rules will remain in the Medicaid Covered Services Rules (7100 - 7700), while other rules will be adopted in the new HCAR collection of Medicaid rules.

Manuals

Applied Behavior Analysis and Mental Health Services. Provider manual with billing instructions for mental health providers.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Dental Supplement. Provider Manual with billing instructions related to the dental claim.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Fee Schedules. Fee Schedule of CPT/HCPCS Codes. 


Archived Provider Manual. The Provider Manual has been merged with the following Supplements: UB04, CMS1500 and Prior Authorization on 10-1-2012. The Detailed Summary of Updates has been removed from this document. 


Archived Appendix to the Provider Manual. This is a companion document to the Archived Provider Manual, it contains: Addresses & Contact Numbers, Glossary of Terms & Phrases, Abbreviations, Voice Response System (VRS), Sample Remittance Advice, Listing of Forms & Manuals, Insurance Coverage Matrix and the Julian Date Calendar.


Durable Medical Equipment Supplement. Provider Manual with billing instructions related to DME supplies.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Federally Qualified Health Centers and Rural Health Clinics. Provider Manual with billing instructions for FQHC and RHC providers.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


General Billing and Forms Manual. Provider Manual with billing instructions for all providers.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


General Provider Manual. Provider Manual with billing instructions for all providers.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Home Health Agency, Assistive Community Care and Enhanced Residential Care. Provider Manual with billing instructions for HHA, ACC and ERC providers.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Non-Emergency Medical Transportation Manual. Provider Manual with billing instructions related to NEMT.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Primary Care Provider Manual. Provider Manual with billing instructions for Primary Care Providers.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Pharmacy Provider Manual. Provider Manual with billing instructions related to pharmacy claims.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Physical Therapy, Occupational Therapy and Speech Language Therapy. Provider Manual with billing instructions for PT, OT and ST providers.

For Agency of Human Services Rules visit https://humanservices.vermont.gov/rules-policies


Vision Supplement.


 

 

Department of Vermont Health Access

280 State Drive
Waterbury, Vermont 05671-1010
Phone: 802-879-5900
Fax: 802-241-0260

Contact List for staff email, telephone & fax numbers

Hours of Operation: Monday-Friday (Excluding Holidays) 7:45am - 4:30pm

Public Record Requests
Kelly Provost
DVHA Public Records Officer
AHS.DVHALegal@Vermont.gov
Visit the Agency of Administration site for the Public Records Database

Report Medicaid Fraud, Waste, and Abuse