Applied Behavior Analysis (ABA) Billing
Providers must use the appropriate modifier(s) when billing ABA services in order to ensure correct reimbursement.
Behavioral Health Precertification Refresher:
Behavioral Health providers may deliver 14 hours of psychotherapy services to a participant, each rolling year, in any combination of individual, family or group therapy (90832, 90834, 90837, 90846, 90847, or 90853).
If you provided individual, family, or group therapy to the participant in the last rolling year a precertification is required to continue services beyond the initial 14 hours.
All covered behavioral health services for participants under the age of 3 require precertification, with the exception of psychiatric diagnostic evaluation (90791, 90792).
Biopsychosocial Treatment of Obesity Policy Clarification
MO HealthNet coverage for biopsychosocial treatment of obesity (see Provider Bulletin Volume 44, Number 12 https://dss.mo.gov/mhd/providers/pdf/bulletin44-12.pdf) is an integrated approach to care that includes both medical nutrition therapy and behavioral health counseling to improve weight status. Prior authorization for either treatment component in isolation will not be granted.
Billing for Behavioral Health Services for Dual Eligible Participants Performed by Non-Medicare Covered Practitioners
When a participant has both Medicare and MO HealthNet coverage, a claim must be filed with Medicare first. However, MO HealthNet enrolls the following practitioners that Medicare does not cover:
Now Statewide Missouri Child Psychiatry Access Project
Are you a Missouri Primary Care Provider who has wished for a curbside consultation with a child and adolescent psychiatrist to support better outcomes for your young patients with behavioral health issues? NOW WITH STATEWIDE IMPLENTATION of MO-CPAP, your telephone can become the tool to make that happen.
Date Change: MO HealthNet Behavioral Health Provider Workshop
The MO HealthNet Division has changed the date of the provider workshop that was to be held on April 29, 2020 in order to avoid a conflict with the 2020 Missouri Children’s Trauma Network Training Summit. The behavioral health workshop will now be held on May 12, 2020.
The ABA workshop will still be held on April 16, 2020.
Complementary Health and Alternative Therapies for Chronic Pain Management: Pre-Certification Process and Billing
Complementary Health and Alternative Therapies for Chronic Pain Management: Pre-Certification Process and Billing
On April 1, 2019, the MO HealthNet Division (MHD) implemented statewide Complementary Health and Alternative Therapy Services for Chronic Pain Management.
The Complementary Health and Alternative Therapy Services program includes a combination of newly covered services: physical therapy, chiropractic therapy, and acupuncture, along with current coverage of cognitive-behavioral therapy (CBT) and non-opioid medication therapy.
Diabetes Training Opportunity for Behavioral Health Providers!
We are alerting you to a world-class behavioral health training for psychologists and other mental health professionals developed by the American Diabetes Association on Saturday, February 29, 2020, in Kansas City. The workshop is co-sponsored by the Missouri Psychological Association (MOPA) and the Kansas City University of Medicine and Biosciences.
Find Treatment for Substance Abuse and Mental Illness
New Behavioral Health Treatment Services Locator:
The Substance Abuse and Mental Health Services Administration (SAMHSA) collects information on thousands of state-licensed providers who specialize in treating substance use disorders, addiction, and mental illness.
This tool includes many resources beyond MO HealthNet providers. This site includes information on treatment options, payment options, and additional resources for understanding addiction and mental health.
Updated MO HealthNet Behavioral Health/ABA Provider Bulletin
The MO HealthNet Division has added clarifying information to Provider Bulletin Vol. 42, No. 04, Rate Increase for Behavioral Health Services.
In Attachment A, Program Type indicates the fee schedule category for each procedure code. In addition, the original bulletin omitted procedure codes for applied behavior analysis (ABA) in error, and the updated bulletin includes ABA procedure codes.