COMRU PASRR LOC Training

COMRU PASRR LOC Training

The Preadmission Screening and Resident Review (PASRR) is a federally mandated screening process that requires all applications (regardless of payment source) to a Medicaid Certified nursing facility bed be given a preliminary assessment to determine whether they might have a serious mental illness (SMI), an intellectual disability/developmental disability (IDD/DD), a related condition, or any combination thereof. This is called a Level I Screening.

Hospice Billing and Policy Workshop, March 24, 2025

Hospice Billing and Policy Workshop, March 24, 2025

MO HealthNet Education and Training will be hosting an in-person Hospice Billing and Policy Workshop on March 24, 2025, in Jefferson City.

Hospice providers will have the opportunity to learn from and speak to all three Managed Care Plans (United HealthCare, Home State Health, and Healthy Blue), Missouri Medicaid Audit and Compliance (MMAC), and the Mo HealthNet Division (MHD) regarding billing practices, resources, audits, and more.

Nursing Facility Patient Status Codes

Nursing Facility Patient Status Codes


When completing a nursing facility claim, providers should ensure they are using the correct Patient Status Code. Providers should ensure that when a MO HealthNet participant is leaving the nursing facility, but plans to return, they use Patient Status Code 30 (Still a patient). For example, if the participant is admitted to the hospital for three days and returns to the nursing facility on the fourth day, the Patient Status should remain 30, “Still a patient.”

Updates to Coverage of Continuous Glucose Monitors (CGMs)

Updates to Coverage of Continuous Glucose Monitors (CGMs):

Effective August 29, 2024, MO HealthNet will expand coverage of Continuous Glucose Monitors (CGMs) to participants currently diagnosed with Gestational Diabetes allowing this vulnerable population to obtain a CGM without a prior authorization.  Claims for a CGM will auto-approve if the participant has had a gestational diabetes diagnosis billed to MO HealthNet recently OR if the pharmacy submits the appropriate gestational diabetes diagnosis code with the claim.

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.

Nursing Home Room and Board

With the exception of certain hospice stays, nursing home room and board is covered under fee-for-service (FFS) regardless of whether the resident is in a Managed Care health plan. Participants who are enrolled in a Managed Care health plan, and who are seeking admission into a nursing home, will remain in a their Managed Care health plan until a nursing home level of care is determined, or for 60 calendar days, whichever comes first.

Durable Medical Equipment (DME) Program Policy Clarification for Custom and Power Wheelchairs Provided in a Skilled Nursing Facility

MO HealthNet has updated the Durable Medical Equipment (DME) Provider Manual to clarify policy related to the physician face-to-face evaluation when providing custom and power wheelchairs in a skilled nursing facility.  The policy clarification can be found in Section 13.18.C of the manual located here(link is external).

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