MedicaidPrior AuthHigh impact
Prior Authorization Bulletin for Cardiology, Diagnostic Imaging, Genetic Testing, Musculoskeletal, Pain Management and Surgical Oncology Services
Missouri Medicaid (MO HealthNet)·MO · Cardiology, Diagnostic Imaging, Orthopedics +2 more·Prior Authorization
Effective date
Mar 23, 2026
We identified it
Jun 20, 2026
Summary
Missouri Medicaid is implementing new prior authorization requirements for multiple medical specialties including cardiology, diagnostic imaging, genetic testing, musculoskeletal procedures, pain management, and surgical oncology services. Billing teams must verify these new prior auth requirements are in place before submitting claims to avoid denials.
Action Required
By March 23, 2026: Billing team must update prior authorization workflows for cardiology, diagnostic imaging, genetic testing, musculoskeletal, pain management, and surgical oncology services for Missouri Medicaid patients. Review the full bulletin at the provided URL to identify specific services requiring prior auth. Update billing system flags and train staff on new requirements. Claims submitted without required prior authorization will be denied.