MO HealthNet Hospital Billing Book

The MO HealthNet (formerly known as Missouri Medicaid) Hospital Billing Book contains information to help providers submit claims correctly to the MO HealthNet program. The information is only for MO HealthNet providers and billers if the provider's MO HealthNet legacy provider number begins with "01". The book is not all inclusive of program benefits and limitations. Providers should refer to specific program manuals for complete information.

CPT codes, descriptions and other data are copyright 2006 (or other such date of publication of the CPT) of the American Medical Association. All Rights Reserved. CPT is a trademark of the American Medical Association (AMA).

Select a topic to view individual sections, or you may download the complete book below. All files are in PDF.

Introduction: Cover Page, Preface and Table of Contents
Section 1: MO HealthNet Program Resources updated 03/31/08
Section 2: UB-04 Claim Filing Instructions — Inpatient Hospital file size: 217KB* updated 03/31/08
Section 3: Revenue Codes - Inpatient
Section 4: Inpatient Hospital Surgical Code Limitations
Section 5: Inpatient Rehabilitation Schedule
Section 6: Inpatient Hospital Certification Reviews updated 03/31/08
Section 7: UB-04 Claim Filing Instructions - Outpatient Hospital file size: 190KB* updated 03/31/08
Section 8: Revenue Codes - Outpatient Hospital Facility updated 03/31/08
Section 9: Outpatient Therapy Procedures
Section 10: The Remittance Advice
Section 11: Medicare Crossover Claim Filing Instructions file size: 1.69MB* updated 03/31/08
Section 12: Medical Pre-certification for Radiological Procedures
Section 13: Participant Co-Pays
Section 14: Frequently Asked Questions
Section 15: Adjustments
Section 16: Second Surgical Opinion
Section 17: Participant Liability file size: 426KB* updated 03/31/08

The complete MO HealthNet Hospital Billing Book 103 pages, file size: 4.02MB* updated 03/31/08

* Depending on your connection speed, download may take a few minutes