Outpatient Facility Fee Reimbursement Policy Effective October 1, 2019
When a clinic visit and emergency room visit are billed by the same hospital on the same claim, this is considered a duplication in facility charges.
Effective October 1, 2019, Missouri Care will deny Revenue Code 510 (clinic visit) as a duplicate when billed with Revenue Code 450,451,459 (emergency room visit) on the same claim. Reimbursement will be made only on the facility charge included as part of the emergency room visit.
