New Provider Updates 07/19/2024

New Updates have been posted to MO HealthNet

July 19, 2024 Bulletins Ambulance Rate Increase Bulletin Ground and Air Ambulance Rate Increases Applies to: MO HealthNet Fee-For Service Ground and Air Ambulance Providers Effective date: July 1, 2024 Ambulance Rate Increases•Ground Ambulance Rates Ground Mileage Rates Air Ambulance Rates Ambulance Rate Increases Pending Centers for Medicare & Medicaid Services (CMS) approval, effective for dates of service on or after July 1, 2024, the MO HealthNet Division (MHD) will increase the fee-for-service maximum allowable rates for ground and air ambulance services. Upon approval of the State Plan amendment by CMS, MHD will update the claims processing system with the indicated maximum allowable reimbursement rates and reprocess claims paid for dates of service on or after July 1, 2024. MHD will reimburse the lesser of the provider's usual and customary billed charge or the maximum allowable amount for the date of service billed. Read More... Hot Tips  Proper Drug Billing Resource The MO HealthNet Pharmacy Program is excited to introduce a new training course on Proper Drug Billing. This convenient training, which can be completed in less than 15 minutes, covers National Drug Codes, how to determine and calculate what quantity to bill, who should bill for white and brown bagged medications, and more. It will serve as a handy resource, as it includes helpful links and contact information. For additional information, contact MHD.PharmacyAdmin@dss.mo.gov and visit our Pharmacy Program page.     New MO HealthNet Provider Resources The MO HealthNet Division (MHD) Education & Training has created two new resources: Medicaid Eligibility Codes – View descriptions of Medicaid Eligibility (ME) Codes and limited and comprehensive benefits Contact Us – View provider contacts for MHD and more to assist with your questions These resources, as well as many others, can be found on our MHD Education & Training page. While you are there, check out our Provider Training Calendar and register for a program specific training. New dates are added every quarter.  Pharmacy Preferred Drug List & Utilization Management Edit Update MO HealthNet is required to complete an annual review of all drug coverage criteria per 13 CSR 70-20.200 Drug Prior Authorization Process. Web page: https://mydss.mo.gov/mhd/pharmacy-clinical-edits-pdl Existing Edit update as of 7/18/2024:  ADHD, Amphetamines Long Acting PDL ADHD, Methylphenidate Long Acting PDL Antiparasitics, Topical PDL Edit Antipsychotics - 2nd Generation (Atypical) Oral & Transdermal Agents Resource List Brand Over Generic Fiscal Edit Covered OTC List GLP-1 Receptor Agonists & Combination Agents PDL Inflammatory Bowel Disease Agents, Oral PDL Edit (formerly Ulcerative Colitis Agents, Oral PDL Edit) Learn More To see all hot tips, bulletins, and newsletters, visit MO HealthNet News. To find more resources, visit the MO HealthNet Provider page. Contact Us For questions about pharmacy or MORx, please email: MHD.PharmacyAdmin@dss.mo.gov. For questions about psychology, exceptions, or medical pre-certifications, please email: Clinical.Services@dss.mo.gov For all other questions or comments, please email: Ask.MHD@dss.mo.gov Our Mission: Empower Missourians to live safe, healthy, and productive lives.     Note: replies to this email address will not be monitored.

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