MO HealthNet Benefit Tables header

Benefit Tables

Benefit Tables show benefits and limitations for each MO HealthNet Program. Refer to specific Provider Manuals for additional information.

A 'Yes' indicator on Benefit Tables or the Master List does not guarantee that all services are covered. Refer to the appropriate provider manual for detailed benefit coverage and program-specific limitations. For questions, contact Provider Communications via eMOMED or by calling (833) 222-7916.

 

Master List
All Benefit Tables
Ambulance (Emergency Only) Benefit Table
Ambulatory Surgical Center Benefit Table
Applied Behavior Analysis Benefit Table
Biopsychosocial Treatment of Obesity Benefit Table
Certified Nurse Practitioner Benefit Table
Chiropractor Medicine Benefit Table
Community Psychiatric Rehabilitation Benefit Table
Complementary and Alternative Therapies for Chronic Pain Management Benefit Table
Comprehensive Day Rehabilitation Benefit Table
Comprehensive Substance Treatment & Rehab (CSTAR) Benefit Table
Dental Benefit Table
Diabetes Prevention Program Benefit Table
Diabetes Self-Management Benefit Table
Doulas Benefit Table
Durable Medical Equipment Benefit Table
Environmental Lead Assessment Benefit Table
Family Planning Benefit Table
Habilitative Therapy - Occupational, Physical & Speech Benefit Table
Hearing Aid Benefit Table
Home Health Benefit Table
Hospice Benefit Table
Hospital - Inpatient Benefit Table
Hospital - Outpatient Benefit Table
Intermediate Care Facility - Intellectual Disabilities Benefit Table
Laboratory & Radiology Benefit Table
Licensed Clinical Social Worker (LCSW) Benefit Table
Licensed Marital Family Therapist (LMFT) Benefit Table
Licensed Professional Counselor (LPC) Benefit Table
Non-Emergency Medical Transportation Benefit Table
Nurse Midwife Benefit Table
Nursing Facilities Benefit Table
Optical Benefit Table
Personal Care Benefit Table
Pharmacy Benefit Table
Physicians and Clinics Benefit Table
Podiatry Benefit Table
Prescribed Pediatric Extended Care Benefit Table
Private Duty Nursing Benefit Table
Program of All-Inclusive Care for the Elderly (PACE) Benefit Table
Psychologist Benefit Table
Targeted Case Management for Individuals with Developmental Disabilities Benefit Table
Targeted Case Management for Mental Illness & Serious Emotional Disturbance Benefit Table
Therapy - Occupational, Physical, and Speech Benefit Table
Transplants Benefit Table
Treat No Transport Benefit Table