MedicaidPrior AuthLow impact
Reminder of Prior Authorization Process for Residential Treatment and Treatment Foster Care
Missouri Medicaid (MO HealthNet)·MO · Psychiatry·Prior Authorization
Effective date
Oct 27, 2025
We identified it
Jun 20, 2026
Summary
MO HealthNet Division reminds providers of prior authorization requirements for Residential Treatment and Treatment Foster Care services, referencing September 2023 guidance. Key points include that Aftercare and Transition TFC services don't require prior auth for the first 6 months, but extensions beyond 6 months need prior approval for up to 30-day periods.
Action Required
Immediately: Billing team should review current processes for H2022 billing with HK, HA, and HE modifiers to ensure proper prior authorization workflows are followed. Verify that Aftercare/Transition TFC services beyond 6 months have prior approval before billing. Update billing system notes to flag H2022 claims requiring extensions beyond initial 6-month period.