The MO HealthNet Division 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"). MO HealthNet providers who test patients for COVID-19 may bill using the newly created HCPCS codes U0001 and U0002.
The MO HealthNet Division 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"). MO HealthNet providers who test patients for COVID-19 may bill using the newly created HCPCS codes U0001 and U0002.
HCPCS code U0001 is used specifically for CDC testing laboratories to test patients for SARS-CoV-2. HCPCS code U0002 allows laboratories to bill for non-CDC laboratory tests for SARS-CoV-2.
There are several bereavement training opportunities offered by Share (Pregnancy & Infant Loss Support). Available are eight online training courses. Live presentations of Companion training and Memory Making are scheduled in February 2020.
All Medicare claims submitted after January 1, 2020, are required to use the new MBI number. Effective January 1, 2020, claims filed without the MBI will deny for a mismatch of DCN/MBI combination not found in the MMIS.
The Medicare Access and CHIP Reauthorization Act (MACRA) required CMS to remove Social Security Numbers (SSNs) from the current SSN-based Health Insurance Claim Number (HICN)
Missouri Dual eligible Medicaid and Medicare participants have received their new cards.
The Department of Health and Senior Services (DHSS) is working with the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), local health departments, and other clinical and public health partners to investigate a multistate outbreak of lung injury associated with use of e-cigarette, or vaping.
The Medicare Access and CHIP Reauthorization Act (MACRA) requires CMS to remove Social Security Numbers (SSNs) from the current SSN-based Health Insurance Claim Number (HICN) and issue a new Medicare card with a Medicare Beneficiary Identification (MBI) number.
CMS has finalized mailing the new Medicare Beneficiary ID cards with the new MBI numbers to participants. Therefore, all Missouri Dual eligible Medicaid and Medicare participant have received their new cards.
Effective with the 4/19/19 Health Care Claim Payment/Advice (835), MO HealthNet implemented a required system change to correct what is reported as the submitted line item charge on the 835 for crossover claims. This will affect 837I (Institutional; Outpatient, Nursing Home, Inpatient, etc.) and 837P Professional (Medical, Dental) claim types.
MO HealthNet does not accept drug prior authorization requests from third party vendors including, but not limited to, CoverMyMeds and ZAPPRX. All requests must originate from the prescriber’s office or pharmacy. Additionally MO HealthNet will not provide any participant or claims information to third party vendors nor accept information or documentation from a third party vendor. Providers may contact Pharmacy Administration at (573) 751-6963 if they have questions.
Missouri Maximum Allowable Cost (MAC) Pricing Inquiry
Providers may contact Pharmacy and Clinical Services at (573) 751-6963 to request review of a MAC rate. If the MO HealthNet Division (MHD) determines there is a rate change, it will be made effective the date of review.
Providers may contact the NADAC Help Desk for support of the NADAC survey, to request review of a NADAC rate, or to provide notification of recent drug price changes not reflected in posted NADAC files.
he NADAC Help Desk may be contacted through the following means:
