What dispute deadlines should providers track in Montana?

Accident Notice: Notice to insurer as soon as reasonably practicable; MedPay Claim Submission: Submission within standard policy billing deadlines (typically 1 to 3 years); Clean Claim Payment Window: 30 calendar days from receipt of clean claim (MCA § 33-18-232). Verify the trigger date, current agency notices, and any extension before acting.

Which agencies administer these rules in Montana?

The guide identifies Montana Office of the Commissioner of Securities and Insurance (CSI). The correct agency depends on the plan and claim jurisdiction.

Auto Accident, PIP & Medical Billing State Guides

Montana Auto Accident, PIP & Medical Billing Laws

Montana operates an At-Fault automobile insurance framework under Title 33 and Title 61 of the Montana Code Annotated (MCA). Motor vehicle liability is governed by modified comparative fault with a 51% bar under MCA § 27-1-702. Montana enforces an absolute Made-Whole rule barring MedPay subrogation until the insured is 100% compensated, and providers enforce statutory medical liens under MCA § 71-3-1111.

Accountability & Review

Reviewed by Millennova Legal Operational Integrity Team, Senior Audit and Arbitration Analysts

Last Reviewed

2026-03-01

Plain-language overview

At-Fault / Traditional Tort (Absolute Made-Whole Doctrine & Montana Medical Lien Act)

Montana is an at-fault tort liability state without mandatory Personal Injury Protection (PIP) insurance. Medical expenses resulting from motor vehicle collisions are covered through optional first-party Medical Payments (MedPay) coverage, private health insurance, or third-party automobile liability insurance. Under longstanding Montana Supreme Court precedent (Swanson v. Hartford Ins. Co.; Conway v. Benefis Health System), an auto insurer has no right of subrogation or reimbursement for MedPay benefits until the injured insured has been completely made whole for all economic and non-economic damages, including attorney fees. Healthcare practitioners and hospitals secure balances using statutory medical liens under MCA § 71-3-1111.

PIP and MedPay coverage

Optional Med Pay Coverage

MedPay is optional in Montana (commonly written in limits of $1,000 to $10,000+ per person), providing no-fault reimbursement for reasonable medical, surgical, dental, hospital, and ambulance expenses resulting from an automobile accident

Absolute Made Whole Rule

Under Montana public policy and common law (Swanson v. Hartford), an automobile insurer cannot subrogate or seek reimbursement from an insured's third-party recovery until the insured is made 100% whole, taking into account all losses and legal expenses

Assignment Of Benefits

Healthcare providers routinely obtain patient assignments of MedPay benefits for direct claims submission to automobile insurers

Medical fee schedule and reimbursement rules

Name

Reasonable and Customary Fee Standard

Rules

Montana does not enforce a statutory fee schedule table for motor vehicle accident medical bills outside of workers' compensation. Providers bill standard reasonable and customary charges prevailing in the local medical community for comparable care.

Cpt Basis

CPT/HCPCS itemized coding on standard CMS-1500 or UB-04 billing claims

Preauthorization and utilization review

Requirement

Preauthorization is not required by statute for emergency medical stabilization or initial acute management. Elective surgical interventions and prolonged physical therapy regimens are evaluated under insurer medical necessity guidelines.

Carrier Examinations

Under standard auto policy terms, insurers may request medical records or independent physician reviews to evaluate causal relationship to the motor vehicle collision.

Appeals and dispute resolution

Prompt Payment Statute

Under MCA § 33-18-232, insurers must pay clean claims within 30 calendar days of receipt. Claims not paid within 30 days accrue statutory interest from the date the claim became overdue.

Medical Lien Act

Under MCA § 71-3-1111 et seq., physicians, nurses, physical therapists, dentists, and hospitals have a statutory lien upon personal injury tort claims, settlements, and judgments for reasonable medical charges. To perfect the lien, the provider must file a notice of lien with the county clerk and recorder within 30 days after services are rendered, and serve written notice on the patient and liability insurer.

Dispute Forum

Montana District Court (county district court) for civil recovery actions.

Claim and dispute deadlines

Deadlines can depend on the trigger event and may be affected by agency relief notices. Confirm the live rule before filing.

Event	Timeframe
Accident Notice	Notice to insurer as soon as reasonably practicable
MedPay Claim Submission	Submission within standard policy billing deadlines (typically 1 to 3 years)
Clean Claim Payment Window	30 calendar days from receipt of clean claim (MCA § 33-18-232)
County Recorder Lien Filing	Must be filed with county clerk and recorder within 30 days of service (MCA § 71-3-1114)
Statute of Limitations	3 years from accident date for personal injury tort claims (MCA § 27-2-204); 8 years for written contracts

Documentation checklist

Montana MedPay Claim Application Form
Executed Assignment of Benefits (AOB) and medical records authorization
Itemized CMS-1500 or UB-04 billing form with CPT/HCPCS codes and ICD-10 diagnostic coding
Contemporaneous medical records, emergency intake documentation, operative reports, and imaging findings
Recorded Notice of Medical Lien with county clerk recording stamp (MCA § 71-3-1114)
Insurer Explanation of Benefits (EOB) or written explanation of claim determination

Responsible agencies

Montana Office of the Commissioner of Securities and Insurance (CSI)Statewide Regulation of Auto Insurers, Rate Filings & Consumer Inquiries

Primary legal and regulatory sources

Montana Code Annotated Title 71, Chapter 3, Part 11 (Medical Liens)Montana Legislative Services Division · 2024
Montana Code Annotated Title 33, Chapter 18, Section 232 (Time for Payment of Claims)Montana Legislative Services Division · 2024

This operational reference is educational, is not legal advice, and does not create an attorney-client relationship.

Common questions

What rules govern auto accident, pip & medical billing state guides in Montana?: Montana operates an At-Fault automobile insurance framework under Title 33 and Title 61 of the Montana Code Annotated (MCA). Motor vehicle liability is governed by modified comparative fault with a 51% bar under MCA § 27-1-702. Montana enforces an absolute Made-Whole rule barring MedPay subrogation until the insured is 100% compensated, and providers enforce statutory medical liens under MCA § 71-3-1111.
What dispute deadlines should providers track in Montana?: Accident Notice: Notice to insurer as soon as reasonably practicable; MedPay Claim Submission: Submission within standard policy billing deadlines (typically 1 to 3 years); Clean Claim Payment Window: 30 calendar days from receipt of clean claim (MCA § 33-18-232). Verify the trigger date, current agency notices, and any extension before acting.
Which agencies administer these rules in Montana?: The guide identifies Montana Office of the Commissioner of Securities and Insurance (CSI). The correct agency depends on the plan and claim jurisdiction.