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).
HIPP Online Application Submission Launch
Health Insurance Premium Program Online Application Submission Launch – April 27, 2026
As part of ongoing efforts to improve accessibility and streamline processes, the MO HealthNet Health Insurance Premium Payment Program (HIPP) will implement a new online application option effective April 27, 2026.
REVISED Diagnosis Code Requirements for Pharmacy Claims
REVISED Diagnosis Code Requirements for Pharmacy Claims
Starting June 1, 2026, MO HealthNet will no longer offer manual overrides for pharmacy claims rejected due to missing or incorrectly formatted ICD-10 diagnosis codes under the Diagnosis Code Required Policy Edit, as found in the Pharmacy Clinical Edits and Preferred Drug Lists.
Self-Measured Blood Pressure (SMBP) Monitoring
Self-Measured Blood Pressure (SMBP) Monitoring
The MO HealthNet Division (MHD) implemented coverage for 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.
SMBP monitoring device limitations include:
Diagnosis Code Requirements for Pharmacy Claims
Diagnosis Code Requirements for Pharmacy Claims
Starting June 1, 2026, MO HealthNet will no longer offer manual overrides for pharmacy claims rejected due to missing or incorrectly formatted ICD-10 diagnosis codes under the Diagnosis Code Required Policy Edit, as found in the Pharmacy Clinical Edits and Preferred Drug Lists.
New Stranded Patient Line for Facilities Assisting Participants with Non-Emergency Medical Transportation
New Stranded Patient Line for Facilities Assisting Participants with Non-Emergency Medical Transportation
Dealing with a scheduled ride that doesn't show up can be stressful for both your staff and your patients. To streamline support, the MO HealthNet Division (MHD) has launched a dedicated Stranded Patient Line to ensure no MO HealthNet participant who has a confirmed ride under the Non-Emergency Medical Transportation (NEMT) Program is left waiting at your facility without a solution.