MO HealthNet Chronic Pain Pilot Program

MO HealthNet Division (MHD) is implementing statewide complementary and alternative therapy services for chronic pain, effective for dates of service on or after April 01, 2019, for participants 21 years of age and older who have evidence of chronic pain. Eligible participants will receive complimentary and/or alternative therapy services as deemed medically necessary.

Chiropractor Chiropractic services will require a Smart prior authorization (PA) for participants 21 years of age and older.
For participants to be eligible for complementary and alternative therapy services the individual must meet the following criteria:

• Be currently enrolled in MO HealthNet, and
• Be 21 years of age or older, and
• Have chronic pain, and
• Have diagnosis within the chronic pain list provided in the MO HealthNet Provider’s Manual for this program.

Chiropractors currently can enroll as a Qualified Medicare Beneficiary (QMB) provider type 75 and specialty 35. However, if Chiropractors wish to enroll under the new, alternative therapy provider type they will need to do one of the following:

• Dis-enroll their currently enrolled number,
• Enroll with a new National Provider Identifier (NPI),
• Enroll with a taxonomy code to keep the same NPI for both the 75-provider type and the new provider type.

This will allow chiropractors to provide services under the Complementary and Alternative Therapies for Chronic Pain Management program and future chiropractic programs.