MedicaidCoverageHigh impact
Temporary Assistance for Pregnant Women Benefits and Limitations for Hospital
Missouri Medicaid (MO HealthNet)·MO · OB-GYN, Family Medicine, Internal Medicine·Provider Notice
Effective date
May 26, 2014
We identified it
Jun 20, 2026
Summary
The Temporary Assistance for Pregnant Women (TEMP) program with ME codes 58 and 59 is limited to ambulatory prenatal care only. Inpatient hospital services are not covered and claims for participants with only TEMP eligibility will be denied.
Action Required
Immediately: Billing team must verify TEMP participants (ME codes 58 and 59) have additional coverage before billing inpatient hospital services. Update system to flag TEMP-only patients for ambulatory prenatal care limitation. Ensure pregnancy or prenatal diagnosis codes are included on all TEMP claims, with illness diagnosis as primary when applicable. Inpatient claims for TEMP-only participants will be denied.