Physician Fee Increases

Effective for dates of service on or after July 1, 2016, the MO HealthNet Division (MHD) fee-for service maximum allowable rates for the Physician Program are increased. Almost 40,000 procedure codes are receiving a rate increase. MHD will reimburse the lesser of either the provider’s usual and customary billed charge or the maximum allowable amount for the date of service billed. Providers may not bill MHD at a higher rate than they charge their private pay patients. The procedure codes that received the increase are provided in Attachment A. The MO HealthNet Division (MHD) will reprocess claims paid for dates of service on or after July 1, 2016. Please check your future remittance advice statements for rate adjustments.