Look Who is Paying for Treatment Without Transport!
Look Who is Paying for Treatment Without Transport!
Certain emergency services are covered by the MO HealthNet Division (MHD) when the participant is not transported to an emergency department. This is referred to as Treat No Transport. A Treat No Transport call can include first responders providing patient care and dispensing medical supplies, but ultimately not transporting the participant to the hospital.
PACE Benefit Table
Program of All-Inclusive Care for the Elderly (PACE) Benefit Table
The Program of All-Inclusive Care for the Elderly (PACE) is administered by MO HealthNet and Medicare to provide comprehensive health care, social, recreational, and wellness services to its participants. One of the main goals of PACE is to allow older adults to live safely in their homes instead of nursing facilities. As of May 3, 2024, PACE organizations are active in St. Louis and Kansas City, with a new PACE organization coming to the Springfield area later this year.
Ambulance Billing for Procedure Code A0428
Ambulance Billing for Procedure Code A0428
The MO HealthNet Division (MHD) requires all MHD enrolled Ambulance providers to use appropriate modifiers when billing. Recently, we noticed some providers have been billing procedure code A0428 (Ambulance service, Basic Life Support (BLS) non-emergency transport) without the appropriate modifiers. A0428 should only be billed in the following circumstances: