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Missouri Medicaid (MO HealthNet)Medicaid · Reimbursement · Provider Bulletin · MO · Physical Therapy, Wound Care, General Practice +1 moreHigh impact

Compression Hose Coverage in the Durable Medical Equipment (DME) Program

Act
by Jun 1, 2026
Effective date
Jun 1, 2026
Identified
Jun 20, 2026

Summary

Effective June 1, 2026, MO HealthNet DME coverage for compression hose changes: adult patients (21+) with qualifying lymphedema diagnoses (ICD-10: I87.2, I89.0, I97.2, M79.6) now have automatic purchase-only coverage; most compression hose codes transition from manually priced (MP) to fixed maximum allowable amounts with invoice cost requirements removed; codes A6519 and A6549 remain manually priced.

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What to do

by Jun 1, 2026 · 8 steps
01Billing team must update billing system to reflect fixed maximum allowable amounts for all compression hose codes listed (A6520, A6522, A6524, A6526, A6528, A6530, A6533, A6534, A6535, A6536, A6537, A6538, A6539, A6540, A6541, A6545, A6552, A6554, A6557, A6575, A6578, A6581, A6582).
02Configure system to automatically allow coverage for adult patients (age 21+) with qualifying lymphedema diagnoses (ICD-10 codes I87.2, I89.0, I97.2, M79.6) without requiring exceptions process.
03Remove invoice cost requirements from claim submission for these codes.
04Verify that codes A6519 and A6549 remain manually priced with no changes.
05Ensure EP modifier handling is correct for patients age 20 and under (coverage remains unchanged per DME Provider Manual).
06Update internal documentation and provider communication materials to reflect new allowable rates.
07Failure to implement changes will result in claim denials or incorrect reimbursement rates.
08Contact Provider Communications at (833) 222-7916 with questions.

Codes mentioned

A6519A6520A6522A6524A6526A6528A6530A6533A6534A6535A6536A6537A6538A6539A6540A6541A6545A6549A6552A6554A6557A6575A6578A6581A6582I87.2I89.0I97.2M79.6

Original notice

Compression Hose Coverage in the Durable Medical Equipment (DME) Program
mydss.mo.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Missouri Medicaid (MO HealthNet) changes →
Revised Compression Hose Coverage in the DME ProgramMediumEffective Jun 1, 2026 · Provider BulletinBrowse every Missouri Medicaid (MO HealthNet) change in the policy list

Related policy hubs

Missouri Medicaid (MO HealthNet) policiesMO policy changesPhysical TherapyWound CareGeneral PracticeVascular SurgeryCode A6519Code A6520Code A6522Code A6524Code A6526Code A6528Code A6530Code A6533Code A6534Code A6535Code A6536Code A6537Code A6538Code A6539Code A6540Code A6541Code A6545Code A6549Code A6552Code A6554Code A6557Code A6575Code A6578Code A6581Code A6582Code I87.2Code I89.0Code I97.2Code M79.6

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