MedicaidReimbursementMedium impact
Outpatient Hospital Services
Missouri Medicaid (MO HealthNet)·MO · Anesthesiology·Provider Notice
Effective date
Jul 20, 2021
We identified it
Jun 20, 2026
Summary
MO HealthNet (Missouri Medicaid) uses the Outpatient Simplified Fee Schedule (OSFS) for all outpatient hospital services with final payments and no cost settlement. Most anesthesia codes (00100-01270 range) are reimbursed at $0.00 (considered packaged) or marked as not covered (NC).
Action Required
For Missouri Medicaid outpatient hospital claims: Billing teams must report all outpatient services at the claim line level using appropriate CPT/HCPCS codes and units. Verify that anesthesia codes are being billed correctly as most are packaged ($0.00) or not covered. Reference the complete OSFS fee schedule at the provided links for current reimbursement rates. Critical access hospitals receive 40% additional payment and nominal charge providers receive 25% additional payment.