Traditional MedicareAdministrativeMedium impact
Billing for Behavioral Health Services for Dual Eligible Participants Performed by Non-Medicare Covered Practitioners
Missouri Medicaid (MO HealthNet)·MO · Psychiatry·Provider Notice
Effective date
Jul 1, 2018
We identified it
Jun 20, 2026
Summary
For dual eligible participants (Medicare + MO HealthNet), certain behavioral health practitioners that Medicare doesn't cover can now bill MO HealthNet directly without filing Medicare first. This includes licensed professional counselors, marital/family therapists, provisional psychologists, and licensed master social workers.
Action Required
Immediately: Billing team must update workflows for dual eligible participants in Missouri. When billing for services by licensed professional counselors, marital/family therapists, provisional psychologists, or licensed master social workers, submit claims directly to MO HealthNet or MO HealthNet Managed Care Plans without requiring Medicare filing first. Update billing system rules to bypass Medicare primary filing requirement for these specific practitioner types.