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Non-Emergency Medical Transportation Program (NEMT) FAQs

What is NEMT?

NEMT stands for Non-Emergency Medical Transportation. The purpose of the NEMT Program is to ensure transportation to eligible MO HealthNet fee for service and Managed Care Health Plan participants who do not have access to free appropriate transportation to and from scheduled MO HealthNet covered services. The NEMT Program may use public transportation or bus tokens, vans, taxis, ambulances, ride-shares, or even airplanes, if necessary, to get participants to health care appointments.

MO HealthNet Outpatient Hospital Simplified Fee Schedule Payment Method FAQs

Effective for dates of service beginning July 20, 2021, all outpatient hospital services are reimbursed based on the Outpatient Simplified Fee Schedule (OSFS). A complete fee schedule of outpatient hospital procedure codes with the MO HealthNet Division (MHD) allowed amount under the OSFS methodology can be found under Fee Schedules.

Missouri Rx Plan - Pharmacist FAQs

What number do I call for questions with processing MORx claims?

Contact Pharmacy Administration at (573) 751-6963.

What is the Missouri Rx Plan (MORx) BIN/PCN? Where should I send the Medicare Part D coordination of benefits (COB) claims?

Use the following BIN/PCN when submitting claims to MORx: 004047/P021011511

Where should I send Medicare Part D excluded drug claims for participants?

Use the following BIN/PCN when submitting excluded drug claims for participants: 004047/P021011511

Missouri Rx Plan - General FAQs

What is MORx?

MORx is Missouri's State Pharmacy Assistance Program. MORx provides prescription drug assistance to Missourians in need by coordinating benefits with Medicare's (Part D) Prescription Drug Plan Program. Individuals receiving Medicare and MO HealthNet benefits are eligible for MORx coverage and automatically enrolled in the program.

Inpatient Certification FAQs

Inpatient hospital admissions must be certified as medically necessary and appropriate before the MO HealthNet Division (MHD) reimburses for inpatient services. All MO HealthNet enrolled hospitals in Missouri and bordering states are subject to this admission certification requirement. The state has given authority for Conduent to receive all the appropriate information necessary to review admissions subject to admission certification.

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