MedicaidAdministrativeMedium impact
Morphine Milligram Equivalent (MME) Factor Update for Hydromorphone, Methadone, and Tramadol
Missouri Medicaid (MO HealthNet)·MO · Pain Management, Palliative Care, Oncology +2 more·Provider Notice
Effective date
Sep 17, 2023
We identified it
Jun 20, 2026
Summary
MO HealthNet updated Morphine Milligram Equivalent (MME) conversion factors for three opioid medications effective September 17, 2023. Hydromorphone MME factor increased from 4 to 5, methadone from 3 to 4.7, and tramadol from 0.1 to 0.2, which will affect opioid claim processing and cumulative MME calculations.
Action Required
By September 17, 2023: Billing team must verify that billing system uses updated MME conversion factors for hydromorphone (5), methadone (4.7), and tramadol (0.2) when calculating cumulative morphine milligram equivalents for MO HealthNet claims. Coordinate with providers to ensure opioid prescriptions account for new conversion factors to avoid exceeding MME thresholds and potential claim denials.