Exception Process Header

The Exception Unit reviews requests for non-covered items and services to be covered. Under certain conditions of medical need, the MO HealthNet Division may authorize payment for a participant to receive an essential medical service or equipment that otherwise exceeds MO HealthNet benefits and limitations. Under specific criteria and on a case-by-case basis, an administrative exception may be made to limitations and restrictions set by agency policy. No exception can be made where requested items or services are restricted or specifically prohibited by state or federal law or regulation, or excluded under the restrictions section of this rule.

Provider Manual


To submit an exceptions request, please complete the appropriate form below and return it to the Exceptions Unit.


MO HealthNet Exceptions Unit

Mail or fax your completed and signed exception form and any accompanying documentation to:

Exceptions Unit
MO HealthNet Division
PO Box 6500
Jefferson City, MO 65102-6500
Fax: 573-522-3061
Helpdesk: 800-392-8030 Option 4