MedicaidPrior AuthMedium impact
Behavioral Health Precertification Refresher:
Missouri Medicaid (MO HealthNet)·MO · Psychiatry·Provider Notice
Effective date
Nov 17, 2023
We identified it
Jun 20, 2026
Summary
Behavioral health providers can deliver up to 14 hours of psychotherapy services per rolling year without precertification. Beyond 14 hours, precertification is required to continue services. All behavioral health services for children under age 3 require precertification except psychiatric diagnostic evaluations.
Action Required
Immediately: Billing team must track psychotherapy hours per participant by rolling year for codes 90832, 90834, 90837, 90846, 90847, and 90853. Obtain precertification before providing services beyond 14 hours annually. For patients under age 3, obtain precertification for all behavioral health services except 90791 and 90792. Update billing system to flag when 14-hour threshold is approaching.