The Benefit Matrix is a practical tool now linked from the MO HealthNet Division’s Provider Participation page. Once a provider navigates to the Provider Participation page, the Benefit Matrix may be found on the left side of the page in the General Information section, underneath the “MO HealthNet Guide — Puzzled by the Terminology?” link. The Benefit Matrix is an Excel spreadsheet that outlines the various benefits and limitations for each of the MO HealthNet programs, as well as cost-sharing, and co-pay amounts.
Providers are encouraged to review this tool and utilize it as a quick reference, when determining what general types of services are covered by each Medicaid Eligible (ME) plan code. While the Benefit Matrix is not meant to replace the Fee Schedule, it has proven to be valuable to providers that want a quick reference of services and ME plan codes.