Missouri Medicaid (MO HealthNet) MNT coverage: codes and limits
The short answerMO HealthNet's practitioner fee schedule marks 97802 and 97803 Covered, at $30.59 and $26.61 per unit, up to 8 units, with no prior authorization. 97804, G0270 and G0271 are Noncovered, and so is 97802 or 97803 billed with modifier TH. The schedule does not say which practitioner types may bill.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Missouri. Public policy, not the member's benefits.
Missouri Medicaid (MO HealthNet)
Medicaid (MHD Practitioner Fee Schedule, Oct. 2026) · Missouri
| 97802 | Listed (covered, max 8 units, no prior authorization. Noncovered with modifiers 80 or TH.) [1] |
|---|---|
| 97803 | Listed (covered, max 8 units, no prior authorization. Noncovered with modifiers 80 or TH.) [1] |
| G0270 | Not listed (noncovered on the practitioner fee schedule.) [1] |
| G0271 | Not listed (noncovered on the practitioner fee schedule.) [1] |
| Where it applies | MO HealthNet Practitioner fee schedule, file dated October 19, 2026. [1] |
| Diagnoses | Not published: call the payer. |
| Other codes | 97804 (group), G0270 and G0271 are Noncovered. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Maximum units column: 8 for both 97802 and 97803 (MHD applies CMS MUEs first and uses this column only where no MUE exists). Prior authorization/pre-certification required: No. [1] |
| Referral and prior auth | Not published: call the payer. |
| Payment | 97802 $30.59 and 97803 $26.61 per unit (rate effective 7/1/2022). [1] |
| Also | 97802 and 97803 billed with modifier TH (obstetrical services) or 80 (assistant surgeon) are Noncovered. The fee schedule says nothing about telehealth for these codes. [1] |
- MO HealthNet Division: Practitioner Fee Schedule (file dated 2026-10-19, Practitioner.xlsx), checked October 30, 2026
Check a Medicaid claim against the row
Before a Missouri Medicaid (MO HealthNet) claim goes out, compare it with the row above: the code is one the policy lists, the place of service and modifier match for a video visit, and the units fit the limit. Change the filters to compare Medicaid with another payer, then download the PDF of what you see.