Mass Adjustment of Claims for Services Requiring Electronic Visit Verification

Mass Adjustment of Claims for Services Requiring Electronic Visit Verification


Due to a temporary system issue, the MO HealthNet Division (MHD) did not apply Electronic Visit Verification (EVV) validation edits to claims received from Personal Care and Home Health Care providers between May 6, 2026, and May 13, 2026. As a result, some claims that should have been denied were accidentally paid, and others missed required informational alerts.

What is Happening Next?

Self-Measured Blood Pressure Monitoring Procedure Codes

Self-Measured Blood Pressure Monitoring Procedure Codes

The MO HealthNet Division (MHD) covers Self-Measured Blood Pressure (SMBP) monitoring effective for dates of service on or after February 1, 2025. These services are covered when prescribed by a physician or a health care professional with prescribing authority. Prescriptions for SMBP-validated monitoring devices must be made to participating Durable Medical Equipment (DME) providers and must include a request for an appropriately sized cuff. 

Notice of Off-Cycle Revalidation Initiative

Notice of Off-Cycle Revalidation Initiative

The Missouri Medicaid Audit & Compliance (MMAC) Unit is issuing this notice to inform select providers of an upcoming, two-phased off-cycle provider revalidation initiative. This initiative is being undertaken in partnership with the Centers for Medicare & Medicaid Services (CMS) and in consultation with the Office of Governor Mike Kehoe and the MO HealthNet Division (MHD).

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