MedicaidPrior AuthHigh impact
Reminder of Precertification Requirements for Behavioral Health, Psychotherapy Services
Missouri Medicaid (MO HealthNet)·MO · Psychiatry·Provider Notice
Effective date
Sep 7, 2023
We identified it
Jun 20, 2026
Summary
MO HealthNet (Missouri Medicaid) now requires precertification for most behavioral health and psychotherapy services for children/youth ages 3-20 and all services for children 0-2 (except diagnostic evaluation). Claims submitted without required precertification will be denied, including telemedicine services.
Action Required
Immediately: Billing team must update system to require precertification for CPT codes 90832, 90834, 90837, 90846, 90847, 90849, 90853 for MO HealthNet patients. Implement precertification checks for: 1) All services for children 0-2 except diagnostic evaluation, 2) Psychotherapy beyond 14 hours for children/youth 3-20 not in state custody, 3) All covered services for foster care children. Contact MHD.Education@dss.mo.gov for questions. Claims without precertification will be denied.