All MO HealthNet Providers

COVID-19: Pharmacy Copayment Exemption

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 is waiving all copays, including the shared dispensing fee for pharmacy services, for the duration of the COVID-19 pandemic effective immediately. MHD has contacted the pharmacy switch vendors to modify the copay requirements. Until these changes are made pharmacies will need to manually waive copays.

COVID-19: 1135 Waiver Implementation for Pre-Admission Screening and Resident Review (PASRR)

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"). 

Effective April 2, 2020 and through the end of the Federal Emergency Declaration, certified Skilled Nursing Facilities and Intermediate Care Facilities may follow the process outlined below for new admissions into Medicaid-certified beds.

Checking Elgibility

MO HealthNet would like to remind providers checking eligibility via eMOMED to wait until after 8:00 a.m. daily.

Updates to the eligibility system occur "overnight." Waiting until after 8:00 a.m. will ensure an accurate response.

COVID-19: New Laboratory 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").

MO HealthNet continues to monitor Centers for Medicare and Medicaid Services (CMS) guidance related COVID-19 testing procedures. The table below lists the COVID-19 testing procedure codes MO HealthNet currently covers as well as their effective dates, max units, and rates.

COVID-19: Home Health

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").

COVID-19: Claims for MO HealthNet Participants with Medicare or Commercial Insurance

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").

MO HealthNet has recently increased flexibilities related to telehealth due to the public health emergency. In some cases MO HealthNet policies may not align with other payers’ policies.

COVID-19: EPSDT - Well-Child Care Visits via Telehealth

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").

Effective March 1, 2020, MHD will allow providers to bill and receive reimbursement for EPSDT services including well-child care visits via telehealth (this includes visits over the telephone) during the COVID-19 crisis. Providers should continue to use appropriate modifiers. POS 02 should be included on all telehealth claims.

COVID-19: Private Duty Nursing (PDN)

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").

In addition to the changes indicated in the MO HealthNet Private Duty Nursing Services Bulletin Volume 42, No. 32 dated March 17, 2020, effective immediately and until the end of the public health emergency due to COVID-19, the following additional changes are implemented for private duty nursing services:

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