MedicaidAdministrativeLow impact
Nursing Facilities and Patient Surplus
Missouri Medicaid (MO HealthNet)·MO · Geriatrics·Provider Notice
Effective date
Apr 28, 2014
We identified it
Jun 20, 2026
Summary
This policy clarifies MO HealthNet (Missouri Medicaid) billing rules for nursing facilities regarding patient surplus (patient liability). Key points include when surplus is collected based on admission timing, how surplus applies only to Medicaid days when both Medicare and Medicaid cover the same month, and billing procedures for hospital readmissions.
Action Required
Billing teams at nursing facilities in Missouri should review Section 13 of the MO HealthNet nursing home manual to ensure compliance with patient surplus billing rules. Verify that billing systems properly apply surplus only to Medicaid days when both Medicare and Medicaid coverage exist in the same month, and confirm proper billing procedures for readmissions after hospital stays.