Providers must be enrolled in the MO HealthNet program to provide medical services. Those who participate in the MO HealthNet Program agree to accept MO HealthNet payment as reimbursement in full for any services provided to MO HealthNet participants. A participant cannot be billed for the difference between the MO HealthNet payment and the provider’s billed charges. MO HealthNet Managed Care services are provided in accordance with the terms and conditions of the contract between MHD and the MO HealthNet Managed Care health plans. Participants enrolled in MO HealthNet Managed Care access services through the health plan’s provider network. The health plan network may include providers not enrolled in the fee-for-service program.
Provider Quick Links
- Hot Tip of the Week
- Electronic Health Records Incentive Program
- Pre–Certification Criteria Documents
- Implementation of 5010 and D.0
Education and Billing
- RA remark codes and claim adjustment reason codes
- Nursing Facility Claims FAQ
- MO HealthNet Training Workshops updated 12/24/15
- Webinar Training updated 01/04/16
- Audio/Visual Training
- Exempt Diagnosis Table updated 01/05/16
- Fee Schedules
- Outpatient Hospital Radiology Fee Schedule, updated 06/10/15
- MO HealthNet Guide — Puzzled by the Terminology? updated 07/07/15
This printable guide explains the various MO HealthNet terms and codes.
- Benefit Matrix
shows the various benefits for each of the MO HealthNet programs, and if they also have cost sharing or any co-pays.
- Provider FAQ
- Apply to become a MO HealthNet provider
- Civil rights, compliance information
- Enrollment guide, information and requirements for new applicants and existing providers
- Provider Enrollment FAQ