Home > Industry News Free Tags

News Tags: Medicaid Missouri

    • July 28, 2017

    Effective for dates of services on or after July 1, 2017, the MO HealthNet Division (MHD) Fee-For-Service maximum allowable rates are reduced by approximately three percent (3%) for the Physician Program. These changes are due to reductions included in the Fiscal Year 2018 budget. The MHD will reimburse the lower of the provider’s billed charge or... more

    Read


    • July 28, 2017

    Effective for dates of services on or after July 1, 2017, the MO HealthNet Division (MHD) Fee-For-Service maximum allowable rates are reduced by approximately three percent (3%) for the Physician Program. These changes are due to reductions included in the Fiscal Year 2018 budget. The MHD will reimburse the lower of the provider’s billed charge or... more

    Read


    • August 31, 2012

    Effective September 1, 2012, the MO HealthNet Division will begin covering the multigene expression assay procedure called Oncotype DX Breast Cancer Assay. This assay predicts outcomes for patients with early stage estrogen receptor (ER)-positive, lymph node-negative breast cancer by examining the tumor at a molecular level. This information is... more

    Read


    • November 22, 2010

    This informational bulletin is to notify you of two policies that CMS and the Medicaid Integrity Group (MIG), Program Integrity is implementing to improve the process whereby Audit Medicaid Integrity Contractors (Audit MICs) conduct audits of Medicaid providers. CMS has developed national standards for: • Look-Back period for... more

    Read


    • January 31, 2011

    MO HealthNet timely filing guidelines for claims and adjustments can be found in Section 4 of Provider Original claims must be filed by the provider and received by the state agency within twelve (12) months from the date of service. Any claims that originally were submitted and received within twelve (12) months from the date of service, but were... more

    Read


    • June 27, 2011

    If you have medical or billing records that have been lost due to a natural disaster, an Attestation of Medical Record Loss or Destruction form should be filled out and kept in your records, in place of the records that have been lost. This form will serve as the replacement for all records lost or destroyed to the point in time of the loss or... more

    Read


    • May 20, 2013

    Due to the increased demand of preliminary drug screens performed in the clinic setting, MO HealthNet has added coverage of procedure code G0434, “Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter”. Coverage is effective for dates of service on or... more

    Read


    • June 27, 2011

    In a bulletin issued on January 20, 2006, titled ëInstructions for Catastrophe/Disaster Related Claims’, providers were instructed to add a ëCR’ modifier to professional claims and ëDR’ Condition code to facility claims for disaster related claims. As a result, providers should use the modifier/condition code for all claims for participants... more

    Read