Please join the MO HealthNet Division and the St. Louis Integrated Health Network for a jointly sponsored event to launch Group Prenatal Care on January 12, 2024. Refer to the invitation for all of the information, or register here.
The Department of Health and Senior Services (DHSS) is offering a free webinar for primary and behavioral health care providers regarding Engaging Individuals in Tobacco Use Disorder Treatment. This webinar is November 16, 2023 from 12pm to 1pm CST. Register now to attend
The training is part of the DHSS Tobacco Cessation Health Systems Change Community of Practice (CoP) webinar series being presented by the Behavioral Health and Wellness Program, University of Colorado.
Effective October 1, 2023, MHD will no longer approve retroactive prior authorization (PA) requests for residential (Qualified Residential Treatment Program (QRTP), non-QRTP, nonInstitution for Mental Disease (IMD) QRTP), and treatment foster care (TFC) services (TFC Level 1 and TFC Level 2).
On March 20, 2020, in response to the COVID-19 outbreak and due to the closure of testing centers administering the Registered Behavior Technician (RBT) exam, the MO HealthNet Division (MHD) published a provider hot tip temporarily waiving the RBT requirement for technicians who met all other requirements but had not taken the RBT exam.
Precertification is required for family, individual, and group psychotherapy (beyond the first fourteen hours) for children and youth, ages 3 through 20 years, who are not in state custody and for children and youth in foster care (ME Codes 07, 08, 37, and 38), not residing in a residential treatment facility. With the exception of diagnostic evaluation, precertification is required for all covered services (i.e., psychological testing and family therapy) provided to children age birth through 2 years, regardless of the ME code or placement of the child.
Effective immediately, all ABA services require precertification. Submitted claims for ABA services without a precertification will be denied.
MO HealthNet Division (MHD) was recently made aware of ABA claim denials due to incorrect limit restrictions for CPT codes 97153 and 97155. MHD has implemented a system fix and as of October 28, 2022, claims are paying correctly. Providers may need to review claim denials based on limit restrictions for the CPT codes mentioned and rebill the claims for reimbursement.
MO HealthNet Division (MHD) covers Biopsychosocial Treatment of Obesity for youth and adults for dates of service on or after September 1, 2021.
Providers must use the appropriate modifier(s) when billing ABA services in order to ensure correct reimbursement.
