MedicaidCoverageMedium impact
Non-Covered vs. Non-Allowable Services
Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Nov 3, 2014
We identified it
Jun 20, 2026
Summary
MO HealthNet has clarified the distinction between non-covered services (not covered by the program or participant's eligibility) and non-allowable services (included in reimbursement for other procedures and not separately billable). Providers must understand this difference to avoid incorrect billing and claim denials.
Action Required
Immediately: Billing team must review MO HealthNet Provider Manual sections on non-covered vs non-allowable services. When claims are denied as 'not covered', verify if the service should be corrected and resubmitted rather than billed to patient. For questions about specific services, contact Provider Communications Unit at (573) 751-2896 before billing.