Fee-For-Service Providers
If you provide services to people with disabilities, seniors, blind & visually impaired, or women with breast or cervical cancer who get their health care services through MO HealthNet, you can provide services through the Fee-For-Service Program. Providers must be enrolled in the MO HealthNet program to provide medical services through the Fee-For-Service Program.
If you participate in the MO HealthNet program, you 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, sometimes called "budget or balance billing."
Policies & Procedures
- Provider Bulletins
- Provider Hot Tips
- Provider Manuals
- Out-of-state non-bordering services
- Policy Updates
Billing
- Apply for EMOMED
- EMOMED
- GEMT Uncompensated Cost Reimbursement Program, updated 10/21/19
- Claims processing and payment schedule
- Exempt Diagnosis Table, updated 10/22/18
- HIPAA - EDI companion guide
- Radiology benefit management information
- Remittance Advice Remark Codes and Claim Adjustment Reason Codes
- School District Administrative Claiming (SDAC)
Provider Forms
General Information
Fee Schedules & Rate Lists
- Fee Schedules
- IRHC Medicare/Medicaid Interim Rate list
- Nursing Facility Rate list
- Outpatient Hospital Radiology Fee schedule, effective 01-01-18, updated 12/04/18
- Outpatient Hospital Radiology Fee schedule, effective 01-01-19, updated 12/04/18
- Outpatient Hospital Radiology Fee schedule, effective 01-01-20, updated 04/09/20
- Outpatient Hospital Surgical Procedural Fee schedule, effective 01-01-19, updated 11/30/18
- Outpatient Hospital Lab Fee schedule, updated 05/26/20
- Complementary Health and Alternative Therapies for Chronic Pain Management Fee Schedule, 04/05/19
Education
- Benefit Tables (formerly Benefit Matrix) This shows the various benefits for each MO HealthNet programs, and if they have cost sharing or co-pays.
- Provider Resource Guide This guide provides descriptions of medical eligibility code, shows limited and comprehensive benefits and provides abundant MO HealthNet contact information.
- Training information Offers provider webinar and workshop schedules, audio/visual trainings, and training booklets.
- Contacting Constituent Education, updated 09/18/19
Provider Enrollment
- Civil rights compliance information
- Enrollment guide information and requirements for new applicants and existing providers
- Missouri Medicaid Audit & Compliance (MMAC)
- Provider enrollment application
MO HealthNet Division
Email Updates
Contact Us
- Provider Communications:
- (573) 751-2896
For questions about claim filing, claims resolution and disposition, and participant verification. - Provider Education:
- (573) 751-6683 or Email
For education about proper billing methods, claim filing, and training information.
To contract with the health plans, contact them directly.
Managed Care Provider Communications:
Email for questions about claims, policy and general questions.