Download MO HealthNet Covered Services

MO HealthNet Covered Services
Fee-for-Services (FFS) and Health Plans cover the following services:
 Ambulance (Emergency, and for under 21 when only
 Public health department services
safe way to transport)
 Ambulatory Surgical Center
 Artificial limbs and adaptive training
 Augmentative Communication Device (includes repair,
replacement, and supplies)
 Braces (orthodontics) for handicapping malocclusions
 Case management (prenatal and lead poisoning)
 Comprehensive Day Rehab for head injury (under 21)
 Clinic Services
 Dental (diagnostic, preventative, treatment)
 Diabetes supplies & self-management training
 Diagnostic Services (MRI, CAT scan, EKG, EEG, etc.)
 Durable Medical Equipment (diapers, orthotics,
prosthetics, oxygen, wheelchair, etc.)
 Emergency room
 Family planning (patient choice)
 Federally Qualified Health Centers (FQHC)
 Hearing Aid (testing, evaluation, fitting, aid, batteries)
 Healthy Children and Youth (HCY) Screens
 Home Health
 Hospice
 Immunizations (childhood)
 Inpatient (medical & behavioral)
 Laboratory
 Lead poisoning screening, testing, and treatment
 Maternity and newborn care
 Radiology (X-ray)
 Non-Emergency Medical Transportation (NEMT)*
• Community Psychiatric Rehab*
 Occupational Therapy (OT) outside an IEP or IFSP
• DMH Waivers (5) *
 Optical (exams & glasses)
 Outpatient hospital
 Personal Care
 Physical Therapy (PT) outside an IEP or IFSP
 Physician
 Podiatry
 Prenatal case management
 Rehab Centers for adaptive training
 Rural Health Clinic (RHC)
 Speech Therapy (ST) outside an IEP or IFSP
 Treatment of STD’s
Carved out of health plans and covered as
Fee-For-Service (FFS) for all
• Environmental Lead Assessment for children with
elevated blood lead levels
• Inpatient Psychiatric (under 21)
• Lab tests required by law (paternity and drug/alcohol
testing by authorized lab covered by MACF)
• Nursing Home
• OT services in an IEP and IFSP (billed by school)
• PT services in an IEP and IFSP (billed by school)
• ST services in an IEP or IFSP (billed by school)
• Pharmacy (Prescription drugs)
• Psychology / Counseling
• Skilled Nursing Facility under 21
• Transplants (organ, bone marrow, corneal)
Department of Mental Health (DMH) Services
• Community Mental Health Centers*
• Comprehensive Substance Treatment and
Rehabilitation (CSTAR)*
* Covered for federal match type of assistance only.
No Co-pay required for any service for any child
in care up to age 21 years.
Review coverage limits before authorizing MACF
payment.
 Private Duty Nursing
Revised 02-2012