RSV Prophylaxis - Update

The MO HealthNet Division (MHD) is aware of the increased positivity of RSV virology in the State of Missouri. MHD will consider RSV prophylaxis prior authorization requests during July & August. For participants who meet the clinical edit requirements, approval will include two doses. For participants who were approved in July the doses will be for July and August, for participants approved in August the doses will be for August and September. MHD will evaluate the need for additional doses on a month-to-month basis, dependent on RSV virology.

RSV Prophylaxis

The MO HealthNet Division (MHD) is aware of the increased positivity of RSV virology in the State of Missouri. MHD will consider RSV prophylaxis prior authorizations requests during July. For participants who meet the clinical edit requirements, approval will include two doses. MHD will evaluate the need for additional doses on a month-to-month basis, dependent on RSV virology. Providers with questions may call MO HealthNet at 800-392-8030.

COVID-19: COVID Testing and Specimen Collection Codes - Revised

The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus.  The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19"). 

MHD continues to monitor the Centers for Medicare and Medicaid Services (CMS) guidance related to COVID-19 testing and specimen collection.  The tables below list the COVID-19 testing and specimen collection procedure codes MO HealthNet currently covers as well as who can bill each code, effective dates, max units, and rates. 

Logisticare Solutions, LLC Changes Name to ModivCare Solutions, LLC

Effective January 6, 2021, MO HealthNet’s Non-Emergency Medical Transportation (NEMT) vendor for fee-for-service participants changed its name from LogistiCare Solutions, LLC to ModivCare Solutions, LLC as part of a company rebranding initiative.  Modiv is Latin for “way”, and reflects the company’s desire to lead innovation and change in terms of how people connect to care.  The new name will not change any of the services provided.

Other changes as part of the rebrand include:

Hot Tip Index

The MO HealthNet Division publishes Hot Tips to supply information to clarify and assist providers in receiving timely reimbursement for services provided and claims disposition.

COVID-19: COVID Testing and Specimen Collection Codes - Updated

The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus.  The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19"). 

The MHD continues to monitor Centers for Medicare and Medicaid Services (CMS) guidance related to COVID-19 testing and specimen collection.  The table below lists the COVID-19 testing and specimen collection procedure codes the MHD currently covers as well as who can bill each code, effective dates, max units, and rates. 

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