MO HealthNet Division (MHD) providers filing claims should choose the correct International Classification of Diseases (ICD) code. The date of service will determine whether the diagnosis code set value must be ICD-9th revision or ICD-10th revision. The date of service determines the ICD code, not the filing date. Providers are encouraged to file claims on the MHD electronic billing portal, emomed.
Starting with dates of service on October 1, 2015, and later, claims will require an International Classification of Diseases (ICD), 10th Revision, Clinical Modification (CM)/Procedure Coding System (PCS), medical diagnosis and/or inpatient procedure code. While October 1, 2015, is fast approaching, there is still time to transition to ICD-10. Centers for Medicare & Medicaid Services (CMS) provide many free tools and resources at www.cms.gov/icd10.
The Non-Emergency Medical Transportation (NEMT) Program may be utilized by participants to receive transportation to their MO HealthNet covered medical appointment. The NEMT broker is LogistiCare Solutions, LLC.
To arrange transportation for an eligible participant, call 1-866-269-5927, Monday through Friday, 8:00 AM to 5:00 PM, at least 5 calendar days before an appointment. Urgent appointments and hospital discharges may be called in 24 hours a day, 7 days a week.
Please access the Claims Processing Schedule for Fiscal Year 2016, for the updated claims processing schedule located on the fiscal agent’s website.
State and federal regulations, 13 CSR 65-2.020, require all currently enrolled MO HealthNet Division (MHD) providers to revalidate their enrollment at least every five (5) years. MMAC has established a revalidation schedule for all currently enrolled providers.
All MO HealthNet Division (MHD) providers are required by federal regulations, 42 CFR 455, and state regulations, 13 CSR 65-2.020, to disclose certain information to Missouri Medicaid Audit & Compliance (MMAC), during their initial enrollment
Missouri Medicaid Audit & Compliance (MMAC) is implementing new provider enrollment procedures, including provider revalidation. Any provider, whose address has changed since initial enrollment, should submit the updated information to MMAC by accessing the “Provider Update Request” form and submitting the changes to MMAC.
The Missouri Medicaid Audit and Compliance (MMAC) website posts information for MO HealthNet Division (MHD) providers and participants. On the MMAC website, the "Contact Us" tab allows users to contact MMAC with their questions. Please utilize this function to submit questions directly to MMAC.
Please protect and secure health information.
Tips for Protecting Protected Health Information (PHI):
On August 31, 2014, Current Procedural Terminology (CPT) code 90655 SL, Influenza virus vaccine, was made non-covered by MO HealthNet Division (MHD).
The Department of Health and Senior Services, (DHSS) is offering an additional vaccine to providers enrolled in the Vaccines for Children (VFC) Program.
MHD reimbursement for the administration of the additional vaccine is effective for dates of service September 12, 2014, and after. The additional vaccine provided through the VFC program is as shown below:
