MedicaidPrior AuthMedium impact
Complementary Health and Alternative Therapies for Chronic Pain Management: Pre-Certification Process and Billing
Missouri Medicaid (MO HealthNet)·MO · Physical Therapy, Chiropractic, Pain Management +2 more·Provider Notice
Effective date
Apr 1, 2019
We identified it
Jun 20, 2026
Summary
MO HealthNet (Missouri Medicaid) requires a two-step pre-certification process for physical therapy, chiropractic therapy, and acupuncture services under their Complementary Health and Alternative Therapies for Chronic Pain Management program. The prescribing provider initiates pre-certification, then the performing provider completes the second step before billing.
Action Required
For Missouri Medicaid patients: Prescribing providers must initiate pre-certification by calling 800-392-8030 (Option 6) or using CyberAccess for physical therapy, chiropractic, and acupuncture services for chronic pain management. Performing providers must complete the second pre-certification step using group (billing) NPI. Always verify patient eligibility on date of service using IVR at 573-751-2896 or eMOMED. Claims will be denied without proper pre-certification.