Physician Program Rates Reduced by 3%-Radiology codes

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 the maximum allowable amount for the date of service billed. Providers may not bill the MHD at a higher rate than they charge their private pay patients. Providers must bill the MHD their usual and customary rate. For ease of reference, the procedure codes that received a decrease are provided in Attachment A. The MHD will reprocess claims paid for dates of service on or after July 1, 2017. Please check your future remittance advice statements for rate adjustments.

INDUSTRY NEWS TAGS: Medicaid Missouri, Radiology News

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