In accordance with 13 CSR 65-2 and 42 CFR 455.432, the MO HealthNet Division (MHD) performs pre- and post-enrollment site visits for new, re-enrolling, and revalidating providers who are designated as moderate or high categorical risks. These visits ensure application accuracy and verify compliance with state and federal standards. However, providers who have completed a site visit through Medicare or another state Medicaid agency within the past two years are exempt from an initial MHD site visit.
For cross-state enrollments, MHD coordinates directly with other Medicaid agencies. Missouri providers attempting to enroll out-of-state should request that the state’s program contact MHD at (833) 818-1183 or MHD.ProviderEnrollment@dss.mo.gov to request a local visit. Conversely, for out-of-state providers seeking MO HealthNet enrollment, MHD will request that the provider’s home state Medicaid enrollment program conduct the required site visit.
Refer to Provider Assigned Risk Categories for provider categorical risk designations.