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Behavioral Health Services - Reminder on Maximum Quantity Changes Effective July 1, 2022

Missouri Medicaid (MO HealthNet)·MO · Psychiatry·Provider Notice
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

MO HealthNet (Missouri Medicaid) changed maximum daily quantities for behavioral health procedure codes effective July 1, 2022. Most psychotherapy and diagnostic codes now have much lower daily limits (many reduced to 1 per day), while some Applied Behavior Analysis codes have higher limits.

Action Required

Action needed
Immediately: Billing team must verify all claims for dates of service July 1, 2022 and later comply with new daily quantity limits. Update billing system rules to prevent submitting units above new maximums (most psychotherapy codes limited to 1 unit per day). Review and resubmit any denied claims that exceeded the new limits. Claims exceeding new daily maximums will be automatically denied.

Affected Billing Codes

90791
90792
90853
90839
96105
96116
96146
97151
97152
97155
97156