The MO HealthNet Division covers the cost of hospital services including inpatient and outpatient services for MO HealthNet eligible participants. An acute inpatient service is one in which the hospital expects to provide service to the member in the hospital for a 24-hour period or longer. Outpatient hospital services are those services provided to a member not admitted by the hospital as an inpatient but is registered on the hospital records as an outpatient and receives services from the hospital.
Resources
- Benefit Tables
- Claims & Billing
- CyberAccess
- FAQs
- Fee Schedules
- Inpatient Stay Exemption by Diagnosis Code Table
- Laboratory Program
- Outpatient Hospital Radiology Fee Schedules 2018 | 2019 | 2020 | 2021
- Outpatient Hospital Laboratory Fee Schedule 2019-2021
- Outpatient Hospital Surgical Procedural Fee Schedule 2019
- Outpatient Hospital Simplified Fee Schedules 2021 | 2022
- Pre-Certification Criteria
- Radiology Program
- Provider Information
MO HealthNet News
The table below provides general information and updates that are relevant to this program page, as well as all MO HealthNet providers. To find information for all other MO HealthNet programs, or to search by date, program or keyword, visit the MO HealthNet News page. If you would like to receive updates in your inbox, subscribe to MO HealthNet News!
| Date | Volume Number | Subject | Type | Program |
|---|---|---|---|---|
| 05/13/2019 | 41-53 | Outpatient Surgical Procedure Billing | Bulletins | Hospital |
| 04/26/2019 | Third Party Vendor Requesting Drug Prior Authorization | Hot Tips | All MO HealthNet Providers | |
| 04/09/2019 | 41-47 | 340B Health Care Facility NDC Requirement | Bulletins | Hospital |
| 02/15/2019 | Reimbursement Issues - Pricing Inquiry Process | Hot Tips | All MO HealthNet Providers | |
| 02/15/2019 | 41-42 | 340B Health Care Facility NDC Requirement | Bulletins | Hospital |
| 02/13/2019 | 41-40 | 2019 Healthcare Common Procedure Coding System | Bulletins | All MO HealthNet Providers |
| 01/31/2019 | 41-38 | Telehealth Originating Site Reimbursement | Bulletins | All MO HealthNet Providers |
| 01/23/2019 | 41-37 | Outpatient Hospital Providers Billing Pharmacy Claims Reimbursement | Bulletins | Hospital |
| 01/02/2019 | 41-36 | Outpatient Hospital Providers Billing Pharmacy Claims Reimbursement | Bulletins | Hospital |
| 12/26/2018 | 41-31 | Outpatient Surgical Procedure Reimbursement and Billing | Bulletins | Hospital |
| 12/21/2018 | 41-30 | Outpatient Radiology Reimbursement Rate Update | Bulletins | Hospital |
| 12/17/2018 | NADAC Pricing Inquiries | Hot Tips | All MO HealthNet Providers | |
| 12/13/2018 | 41-29 | Medicare Crossover Claims | Bulletins | All MO HealthNet Providers |
| 10/17/2018 | 41-25 | ICD-10 Annual Updates 2018 | Bulletins | All MO HealthNet Providers |
| 10/12/2018 | 41-24 | Ordering Prescribing and Referring Provide Requirements | Bulletins | All MO HealthNet Providers |