Missouri Code of State Regulations
Title 13 - DEPARTMENT OF SOCIAL SERVICES
Division 70 - MO HealthNet Division
Chapter 90 - Home Health Program
Section 13 CSR 70-90.020 - Home Health-Care Services Reimbursement

Universal Citation: 13 MO Code of State Regs 70-90.020

Current through Register Vol. 49, No. 18, September 16, 2024

PURPOSE: The purpose of this amendment is to remove outdated information from section (1) and to add section (2) which contains requirements regarding non-routine supply reimbursement.

(1) MO HealthNet reimbursement for covered home health services provided to eligible individuals shall be made at the lower of-

(A) The provider's billed charge for the service; or

(B) The MO HealthNet maximum allowable fee for service. The fee schedule is available at www.dss.mo.gov/mhd/providers/index.htm.

(2) MO HealthNet reimbursement for covered non-routine supplies is the lower of-

(A) The provider's billed charge for the non-routine supply; or

(B) The home health non-routine supply cost. The home health non-routine supply cost is defined as the invoiced acquisition cost of the supply multiplied by two (2) to cover the cost for overhead (including taxes and shipping). Invoiced acquisition cost is defined as the amount shown on the invoice received for purchase of the supply which must include any reduction in cost the provider receives (i.e., discounts, allowances) and does not include shipping or sales tax.

*Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986, 1993; 208.152, RSMo 1967, amended 1969, 1971, 1972, 1973, 1975, 1977, 1978, 1978, 1981, 1986, 1988, 1990, 1992, 1993, 2004, 2005, 2007; 208.153, RSMo 1967, amended 1967, 1973, 1989, 1990, 1991, 2007; and 208.201, RSMo 1987, amended 2007.

Disclaimer: These regulations may not be the most recent version. Missouri may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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