Welcome to the MO HealthNet Pharmacy Program. The MO HealthNet Pharmacy Program oversees reimbursement for outpatient, fee-for-service prescription drugs, over-the-counter products and devices. The program is responsible for pharmacy program and policy development and uses best practices and evidence-based medicine to drive clinical policy development. Pharmacy Administration is responsible for the pharmacy program and policy development for MHD. Contact Pharmacy Administration at MHD.PharmacyAdmin@dss.mo.gov or call (573) 751-6963.
Education & Training
- Alcohol Use Disorder Treatment Options
- Albuterol Limit for Prescribers
- MO HealthNet Education & Training
- Opioid Policy Update
- Opioid Reversal Agents
- Pharmacy Billing Medical Claims
- Pharmacy Prior Authorization Process
- Pharmacy Provider Resource Guide
- Proper Drug Billing Course
Forms
- Provider Forms
- ADHD Medication Prior Authorization Children Less than 6 Years Old
- Antipsychotic Children less than 9 years old Prior Authorization
- Benzodiazepine Prior Authorization
- Compound Prior Authorization
- Continuous Glucose Monitoring Device Tubeless Insulin Pump Prior Authorization
- Diabetic Supplies Prior Authorization
- Drug Prior Authorization
- GLP-1 Receptor Agonists for All Indications Prior Authorization
- Growth Hormone Somatropin Agents Prior Authorization
- Hepatitis C Treatment Prior Authorization
- Opioid Prior Authorization
- Psychotropic Medication Polypharmacy Prior Authorization
- Request for Brand Name Drug Prior Authorization
- Spravato Prior Authorization
- Synagis Prior Authorization
- Targeted Immune Modulators Prior Authorization Misc Allergy and Asthma-related Monoclonal Antibodies
Provider Manual
Resources
- Claims & Billing
- Drugs Carved Out of Inpatient Rate
- Drugs Carved Out of 340B Reimbursement
- Drugs with Coverage Limitations and New Drug Review
- FAQs
- Fee Schedules
- Missouri Maximum Allowable Cost For Specific Drug Products
- New Drug AMCP Guidelines (Abbr.) and Cover Letter - 9.1.19
- New Drug Review Process
- Provider Information
MO HealthNet News
The table below provides general information and updates that are relevant to this program page, as well as all MO HealthNet providers. To find information for all other MO HealthNet programs, or to search by date, program or keyword, visit the MO HealthNet News page. If you would like to receive updates in your inbox, subscribe to MO HealthNet News!
| Date | Volume Number | Subject | Type | Program |
|---|---|---|---|---|
| 12/02/2025 | MO HealthNet Education and Training – 1st Quarter Provider Training Schedule Now | Hot Tips | All MO HealthNet Providers | |
| 11/24/2025 | New DSS Benefits Portal Webpage Now Available | Hot Tips | All MO HealthNet Providers | |
| 11/24/2025 | Updates to the MO HealthNet General Sections Manual | Hot Tips | All MO HealthNet Providers | |
| 11/18/2025 | 48-30 | Implementation of Maximum Daily Limits for Drugs on Crossover Claims | Bulletins | All MO HealthNet Providers |
| 11/14/2025 | Spend Down Got Easier – Now It’s Faster! | Hot Tips | All MO HealthNet Providers | |
| 10/24/2025 | 48-22 | Billing ICD-10 Diagnosis & Procedure Codes | Bulletins | All MO HealthNet Providers |
| 10/23/2025 | Telemedicine | Hot Tips | All MO HealthNet Providers | |
| 10/10/2025 | Tobacco Prevention to Promote Health Equity | Hot Tips | All MO HealthNet Providers | |
| 10/02/2025 | 48-18 | Sunset of Direct Care Pro Provider Bulletin | Bulletins | All MO HealthNet Providers |
| 10/01/2025 | 48-17 | Pharmacy Program Reimbursement Dispensing Fee Decrease | Bulletins | Pharmacy |
| 10/01/2025 | MO HealthNet Provider Webinars Scheduled October - December 2025 | Hot Tips | All MO HealthNet Providers | |
| 10/01/2025 | Autism Support Now ABA Panel Discussion | Hot Tips | All MO HealthNet Providers | |
| 10/01/2025 | MO HealthNet Provider Newsletter - October 2025 | Newsletters | All MO HealthNet Providers | |
| 09/30/2025 | Additional - 2025 Optimizing Benefits for Maternal and Infant Health Meetings | Hot Tips | All MO HealthNet Providers | |
| 09/29/2025 | MHD Offers Office Hours for Notification of Pregnancy Billing | Hot Tips | All MO HealthNet Providers |