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Revised Compression Hose Coverage in the DME Program
Effective date
Jun 1, 2026
Identified
Oct 27, 2026
Summary
Missouri MO HealthNet (Medicaid fee-for-service) revised its compression hose coverage for durable medical equipment. Effective June 1, 2026, adults aged 21 and older are covered for listed compression garments as purchase-only items only with a qualifying lymphedema diagnosis, and most listed garments move from manual pricing to set maximum allowable amounts. The bulletin was posted October 26, 2026, after its June 1 effective date, so the changes already apply to dates of service from June 1, 2026 onward.
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What to do
Action · 7 steps
01Already effective June 1, 2026 (dates of service on or after that date): Billing team, for adult MO HealthNet participants aged 21 and older, bill the listed compression garments as purchase-only items only when the chart documents a lymphedema diagnosis from the listed ICD-10 codes (I87.2, I89.0, I97.2 and the M79.6 codes in the bulletin); confirm this in the claim's diagnosis fields and charge entry.
02For adults without a qualifying lymphedema diagnosis, the bulletin says requests continue through the Exceptions Process, so follow the Exceptions Provider Manual for those.
03Billing team, in the DME fee schedule and charge entry, update the listed HCPCS codes to the new maximum allowable amounts shown in the bulletin, and stop submitting invoices of cost for those codes, except A6519 and A6549, which remain manually priced.
04Participants aged 20 and under billed with the EP modifier are not affected.
05Before service, verify eligibility, and confirm with each Managed Care plan how the bulletin applies, since some services are carved out to fee-for-service.
06Questions about claims: Provider Communications through eMOMED or (833) 222-7916.
07The bulletin does not state consequences for non-compliance.
Codes mentioned
A6519A6520A6522A6524A6526A6528A6530A6533A6534A6535A6536A6537A6538A6539A6540A6541A6545A6549A6552A6554A6557A6575A6578A6581A6582I87.2I89.0I97.2M79.601M79.602M79.603M79.604M79.605M79.606M79.609M79.621M79.622M79.629M79.631M79.632M79.639M79.641M79.642M79.643M79.644M79.645M79.646M79.651M79.652M79.659M79.661M79.662M79.669M79.671M79.672M79.673M79.674M79.675M79.676
Original notice
Revised Compression Hose Coverage in the DME Program
mydss.mo.gov · Always check the source before changing claims.
Related changes
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Missouri Medicaid (MO HealthNet) policiesMO policy changesVascular SurgeryPhysical TherapyWound CareCode A6519Code A6520Code A6522Code A6524Code A6526Code A6528Code A6530Code A6533Code A6534Code A6535Code A6536Code A6537Code A6538Code A6539Code A6540Code A6541Code A6545Code A6549Code A6552Code A6554Code A6557Code A6575Code A6578Code A6581Code A6582Code I87.2Code I89.0Code I97.2Code M79.601Code M79.602Code M79.603Code M79.604Code M79.605Code M79.606Code M79.609Code M79.621Code M79.622Code M79.629Code M79.631Code M79.632Code M79.639Code M79.641Code M79.642Code M79.643Code M79.644Code M79.645Code M79.646Code M79.651Code M79.652Code M79.659Code M79.661Code M79.662Code M79.669Code M79.671Code M79.672Code M79.673Code M79.674Code M79.675Code M79.676