MedicaidCoverageMedium impact
Nursing Home Room and Board
Missouri Medicaid (MO HealthNet)·MO · Geriatrics, Family Medicine, Internal Medicine·Provider Notice
Effective date
Jan 31, 2023
We identified it
Jun 20, 2026
Summary
Nursing home room and board is now covered under fee-for-service (FFS) regardless of whether the resident is in a Managed Care health plan, with certain hospice exceptions. Participants in Managed Care plans remain enrolled until nursing home level of care is determined or for 60 days maximum, requiring MHD verification of DA-124 form.
Action Required
Immediately: Billing team must understand that nursing home room and board should be billed under fee-for-service regardless of patient's Managed Care enrollment status. For Managed Care patients seeking nursing home admission, ensure MHD has verification of DA-124 form before the 60-day transition period begins. Review Provider Bulletin Volume 45, Number 22 for detailed guidance on nursing home program changes.