MedicaidAdministrativeMedium impact
Maximum Daily Units Edits
Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Aug 19, 2018
We identified it
Jun 20, 2026
Summary
Missouri Medicaid (MO HealthNet) is implementing maximum daily quantity edits for drug claims effective August 19, 2018. Claims submitted for quantities above the maximum daily units allowed will be automatically denied, and providers must ensure correct day's supply calculations based on prescriber directions.
Action Required
Before August 19, 2018: Pharmacy and billing staff must verify all drug claim quantities do not exceed maximum daily units as determined by MHD or First Databank's MedKnowledge. Update billing procedures to ensure correct day's supply calculations based on quantity dispensed and prescriber directions. Claims exceeding maximum daily quantities will be denied and subject to recoupment.