MedicaidCoverageMedium impact
Reimbursements for Circumcisions
Missouri Medicaid (MO HealthNet)·MO · Pediatrics, Family Medicine, Urology +1 more·Provider Notice
Effective date
Jun 15, 2014
We identified it
Jun 20, 2026
Summary
MO HealthNet (Missouri Medicaid) now covers elective circumcisions for all newborn infants less than 28 days old using CPT codes 54150 and 54160, removing the previous requirement for two physicians to document medical necessity. This policy change was effective June 15, 2014.
Action Required
Immediately: Update billing procedures for Missouri Medicaid patients to allow elective circumcisions for newborns less than 28 days old using CPT 54150 and 54160 without requiring prior documentation of medical necessity from two physicians. Continue to obtain Prior Authorization for CPT codes 54161, 54162, 54163, and 54164.