MedicaidCoverageMedium impact
School/Athletic Physicals and Vaccines
Missouri Medicaid (MO HealthNet)·MO · Family Medicine, Pediatrics, General Practice +1 more·Provider Notice
Effective date
Aug 8, 2023
We identified it
Jun 20, 2026
Summary
MO HealthNet covers school and athletic physicals for eligible children using specific diagnosis codes Z00.121/Z00.129 and preventive medicine CPT codes. Providers must participate in the VFC Program and use free vaccines for qualified children, with administration fees billable separately except for RHCs and FQHCs.
Action Required
Immediately: Billing team must ensure school/athletic physicals use diagnosis codes Z00.121 or Z00.129 with appropriate preventive medicine codes 99381-99385 or 99391-99395. Providers must enroll in VFC Program and use free vaccines for eligible children. Bill vaccine administration fees separately except for RHC/FQHC providers who cannot bill additional administration fees.