Checking Elgibility
MO HealthNet would like to remind providers checking eligibility via eMOMED to wait until after 8:00 a.m. daily.
Updates to the eligibility system occur "overnight." Waiting until after 8:00 a.m. will ensure an accurate response.
COVID-19: New Laboratory Codes - Updated
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
MO HealthNet continues to monitor Centers for Medicare and Medicaid Services (CMS) guidance related COVID-19 testing procedures. The table below lists the COVID-19 testing procedure codes MO HealthNet currently covers as well as their effective dates, max units, and rates.
COVID-19: Home Health
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
COVID-19: Personal Care Program Services
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
COVID-19: Claims for MO HealthNet Participants with Medicare or Commercial Insurance
- Read more about COVID-19: Claims for MO HealthNet Participants with Medicare or Commercial Insurance
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
MO HealthNet has recently increased flexibilities related to telehealth due to the public health emergency. In some cases MO HealthNet policies may not align with other payers’ policies.
COVID-19: EPSDT - Well-Child Care Visits via Telehealth
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
Effective March 1, 2020, MHD will allow providers to bill and receive reimbursement for EPSDT services including well-child care visits via telehealth (this includes visits over the telephone) during the COVID-19 crisis. Providers should continue to use appropriate modifiers. POS 02 should be included on all telehealth claims.
COVID-19: Private Duty Nursing (PDN)
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
In addition to the changes indicated in the MO HealthNet Private Duty Nursing Services Bulletin Volume 42, No. 32 dated March 17, 2020, effective immediately and until the end of the public health emergency due to COVID-19, the following additional changes are implemented for private duty nursing services:
COVID-19: CPAP and NiPAP/Sleep Studies Criteria
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
Sleep Studies
During this event, the MHD will cover non facility-based, non-attended Polysomnographic studies (95800, 95801 and 95806).
CPAP/BiPAP
COVID-19: Sedative Hypnotic Preferred Drug List
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
COVID-19: Missouri receives approval from Centers of Medicare & Medicaid Services of 1135 waiver request to COVID-19
On March 13, 2020, the President of the United States issued a proclamation that the COVID-19 outbreak in the United States constitutes a national emergency. On the same day, the Secretary of the United States Department of Health and Human Services invoked his authority to waive or modify certain requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP).