The information in this provider hot tip applies to services for MO HealthNet fee-for-service covered participants.
Please remember that prior authorization is required for residential treatment, treatment foster care. Below are tips to help speed the approval process:
- Requests for prior authorization must include the facility NPI and the taxonomy code associated with the agency’s Community Psychiatric provider type.
- Documentation accompanying the prior authorization form must include recent clinical records such as the treatment plan and prescriber progress notes.
- The Prior Authorization Request form has been updated. Please indicate in box 1 if the request is for an initial authorization or re-authorization. Prior authorization requests should be faxed to (573) 659-0207.
- Please include the dates requested (fields 19-20) and the number of units (days) requested (field 22). There are online tools to assist with calculating the number of days in a date span, here is one example. Be sure to include the end day for accuracy.
- Prior authorization is not required for six months of residential aftercare.
Questions about prior authorization may be emailed to MHD.BehavioralHealth@dss.mo.gov
In eMOMED, when billing for residential treatment or treatment foster care services (e.g., H0019, H2020, H2022), after entering the facility NPI, providers must select the taxonomy code associated with the Community Psychiatric provider type (if the NPI is also associated with other provider types such as Clinic). Contact Provider Communications at (573) 751-2896 for questions about filing claims or claims disposition.