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Missouri

Missouri Behavioral Health Credentialing and Payer Enrollment

Missouri writes the credentialing clock into statute, and it starts fast. Under RSMo 376.1578 a carrier has two working days to acknowledge your application, ten days after that to ask for anything missing, and 60 days from a completed file to decide. It also has to run a status portal you can check yourself. There’s money attached too, and one condition on it that decides whether you get any. Here’s the real Missouri path, plus the Blue map that sends half the state to a different door.

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Missouri payers and timelines

Why Missouri is different

One strong statute, one big condition, and two Blues.

Missouri hands you more legal footing than most states and then attaches a limit that changes which package fits you. Read the second card before you plan cash flow.

Two working days, then sixty

RSMo 376.1578
  • The carrier has two working days to send you a notice of receipt, and ten days after that notice to request anything missing before your application counts as complete
  • 60 days from a completed application to approve or deny and tell you
  • It also has to give you a provider web portal where you can see the status of an electronically submitted application. Most people never ask for it. We use it
  • Honest limit: applications disclosing substance use or behavioral disorders, licensure discipline, revoked or restricted hospital privileges, or malpractice judgments are carved out of the 60-day clock by design. A file with history in it takes longer, and that isn’t the carrier stalling

Back pay, with one condition that decides everything

The part most summaries skip
  • Once the carrier approves you, it has to pay for covered services you performed during the credentialing period, from the date you submitted a completed application through approval
  • The condition: those services have to have been delivered through a contracted entity
  • So a provider joining a clinic that already holds the contract is inside the protection. A solo practice building its first panels usually isn’t, because there’s no contracted entity yet. That’s not a technicality, it’s the whole difference
  • If you are covered: six months after approval to submit those claims, and you can’t bill the patient for that period. Hold the claims instead of writing them off

CAQH is the Missouri form, in regulation

RSMo 354.442 and 20 CSR 400-7.180
  • Missouri names its credentialing form in rule, which is unusual. The Department of Commerce and Insurance develops a standard credentialing form all health carriers must use for professionals in a managed care plan
  • The rule adopts the CAQH Universal Credentialing DataSource form as that standard, for credentialing and recredentialing, and substantially similar forms are allowed only with prior approval
  • Plain effect: an unattested or unauthorized CAQH profile doesn’t slow one application, it stalls every commercial application at once
  • Carelon adds a Missouri wrinkle on top. It asks behavioral health providers to set CAQH access to Global so it can see your data

Two Blue licensees inside one state

And they use different behavioral health vendors
  • Anthem Blue Cross and Blue Shield covers most of Missouri, operating as RightCHOICE Managed Care, Healthy Alliance Life Insurance Company and HMO Missouri
  • Blue Cross and Blue Shield of Kansas City covers 30 Missouri counties around Kansas City, plus Johnson and Wyandotte counties in Kansas
  • Anthem routes behavioral health to Carelon. Blue KC routes it to Lucet, formerly New Directions. Same colour on the card, completely different front door
  • If your patients come from both sides of the state, reaching the full in-state Blue population takes both contracts. That’s a different thing from needing a contract per state

Separate doors: Carelon for Anthem, Lucet for Blue KC

Where the delays actually happen

Getting on a panel isn’t the same as getting paid.

Most of the waiting happens in the gaps between these five steps. We work all of them, and we tell you which one you’re actually sitting in.

Credentialed›contracted›loaded›connected›payable

Two tracks

Medicaid and commercial work differently here.

Most Missouri practices want both. The commercial side has the statute behind it. The Medicaid side has a sequencing rule you can’t skip and an enrollment category you can pick wrong.

MO HealthNet

MMAC first, plans second, and pick your category before you start.

Enrollment is Missouri Medicaid Audit and Compliance‘s job, not the MO HealthNet Division’s and not the health plans’. Managed care went statewide on May 1, 2017 across all 114 counties and the City of St. Louis, but aged, blind and disabled members and several other groups stay fee-for-service. So a Missouri behavioral health panel usually holds both kinds of patient.

The categories, and why they matterBilling or performing if you’ll submit claims. MCO Network Provider if you’ll only ever see managed care members, and that one is required rather than optional. Ordering, Prescribing and Referring for a prescriber who never bills. Picking wrong is the most common way a Missouri enrollment gets sent back.
Forms you’ll actually see

Individual MCO Network Provider ApplicationOrganization MCO Network Provider ApplicationOPR QuestionnaireOPR Enrollment ApplicationTitle XIX Participation Agreement

The plans, and a rebid in progressHome State Health, Healthy Blue and UnitedHealthcare Community Plan hold statewide MO HealthNet Managed Care contracts, plus Show Me Healthy Kids, the statewide foster care specialty plan run by Home State Health. The state released a new statewide managed care RFP on July 1, 2026, proposals due September 2, 2026, readiness reviews January through March 2027. The lineup you contract with today is being rebid right now.
Two program lines that aren’t yoursCommunity Psychiatric Rehabilitation and Comprehensive Substance Treatment and Rehabilitation are carved out of managed care and paid fee-for-service, and the agencies delivering them are certified by the Department of Mental Health. Those are agency programs, not something a solo prescriber bills. Missouri also has 18 Certified Community Behavioral Health Clinics covering all 114 counties on a prospective payment rate, which is why so much public behavioral health money here moves through agencies.
Revalidation, and a late one costs more than you thinkEvery active provider revalidates at least every five years, and the rule says the revalidation application is due no later than 120 days before your current agreement expires. MMAC draws a hard line between revalidation and reenrollment. Let it lapse and a renewal becomes a brand new application with a new screening. One softer note: the rule allows retroactive enrollment up to 365 days before the actual enrollment date where program rules permit, so a late application isn’t automatically a lost year.

Commercial

The statute helps. The Blue map decides your list.

Missouri gives commercial applicants a statute to point at, and then makes the geography do the work. Which Blue you apply to, and which behavioral health vendor sits behind it, is set by which counties your patients come from.

Your CAQH stays yoursYou complete and attest your own profile. We’re added as an authorized practice manager, so we keep the practice data current and get each payer authorized. We never ask for your password. In Missouri that profile is the state-adopted credentialing form, so it does more work here than almost anywhere.
Behavioral health has its own door at nearly everyoneAnthem routes to Carelon Behavioral Health through Availity. Blue KC routes to Lucet. UnitedHealthcare routes to Optum through Provider Express. Cigna routes to Evernorth. Aetna keeps it in house but on a separate behavioral health request for participation. Applying through a carrier’s medical door is the single most common and most expensive mistake in this state.
The state employee book rides on AnthemThe Missouri Consolidated Health Care Plan covers state employees and many public entities, and for 2026 its medical coverage on the HSA, PPO 1250 and PPO 750 plans runs on Anthem’s nationwide network. You reach those members through the Anthem contract, not a separate MCHCP one. In Jefferson City and anywhere else with heavy state employment, that’s a real argument for Anthem.
Blue KC is a need decision before it’s a queueYou submit a Network Interest Application, a Network Interest Committee decides whether there’s a need for you, and only then does a credentialing form come your way. Its published minimum criteria are unusually specific, including ten years of work history rather than the usual five and, for advanced practice providers, an in-network Blue KC provider named as collaborating or supervising physician with the agreement attached. That’s Blue KC’s own network criterion rather than a state rule, and it’s separate from what Missouri allows you to do clinically.
Seeing patients in other statesAetna, Cigna and UnitedHealthcare are national, so one contract covers every state you’re licensed in. Anthem Missouri and Blue KC both reach out-of-state Blue members through BlueCard. What you need is a licence where the patient is, not another contract. Medicaid is the genuine exception, and MMAC enrollment doesn’t travel.

Missouri commercial payers

Who you’ll apply to, and how long it usually takes.

These are typical ranges from a complete application, with Missouri’s 60-day statutory decision sitting underneath the carriers subject to it. That clock is a ceiling rather than a statement about queue depth, and payers control their own timelines, so we track them rather than promise them.

Anthem Blue Cross and Blue Shield of Missouri

Most of the state, plus the state employee book
  • Usually: Anthem doesn’t publish a single Missouri number. Plan on the statutory shape: two working days to acknowledge, ten days to request missing items, 60 days from a completed application to decide. Confirm the working turnaround at submission
  • Behavioral health: Carelon Behavioral Health, submitted in the Carelon payer space on Availity. Five steps, apply then eligibility review then contract then credential then activate, with recredentialing at least every three years. Carelon wants your CAQH access set to Global
  • Bonus coverage: your Anthem contract is how you reach MCHCP members, the state employee plan, on Anthem’s nationwide network for 2026
  • Reach: BlueCard carries you to Blue members from other states when you’re licensed there

Separate door: Carelon Behavioral Health

Blue Cross and Blue Shield of Kansas City

30 Missouri counties, and the most specific criteria in the state
  • Usually: roughly 45 to 60 days once your CAQH information is accurate and complete. Completed files go to the Corporate Credentials Committee, which meets monthly, and you get a written decision within 10 business days of that meeting
  • Two hard edges: Blue KC won’t process a credentialing application older than 180 days, and claims you submit while credentialing is pending process out of network with payment going to the member unless the law requires otherwise. In Missouri that phrase has teeth, and it points back at RSMo 376.1578
  • Sequence: CAQH and Blue KC authorization, current NPPES and PECOS records, then the Network Interest Application, then a Network Interest Committee decides whether there’s a need, then credentialing
  • Minimum criteria to have ready: current Missouri licence, a DEA certificate showing the current practice location, a valid Missouri BNDD certificate, malpractice coverage of at least $1,000,000 per claim and $3,000,000 aggregate, ten years of work history with any gap over six months explained, and for advanced practice providers an in-network collaborating or supervising physician with the agreement attached
  • Watch: Blue KC administratively terminates providers who file no claims for a full year, on September 1 and March 1, with 90 days notice and one six-month extension available on request

Separate door: Lucet, formerly New Directions

UnitedHealthcare and Optum

The strongest published signal in the state
  • Usually: 60 to 120 days from a complete application, with the 60-day statutory decision applying once your file is complete
  • Path: behavioral health starts in Provider Express through Join Our Network. Optum states plainly that CAQH participation is required for credentialing in Missouri and wants your CAQH ID before you start
  • Why it’s first or second: Optum’s Missouri page recognises Missouri as an any willing provider state and lists MDs, DOs, PAs and RNs with prescriptive authority as accepted in all Missouri counties, plus telemental health, medication-assisted treatment prescribers, Express Access providers who can see a member within five business days, and EAP services
  • Watch: the Community Plan (Medicaid) line is a separate contract from commercial

Separate door: Optum Behavioral Health

Cigna Healthcare and Evernorth

Paused right now, nationally
  • Right now: Evernorth paused new individual and clinic behavioral health applications on June 1, 2026 and tells providers to check back after September 1, 2026. Facilities, including residential settings and partial hospitalization and intensive outpatient programs, can still apply, and anything started before June 1 keeps processing
  • What we do: there’s a Provider Interest Form you can file now to be contacted when it reopens. We file it, then we queue the application rather than putting a paused panel in your opening set
  • Usually: up to about 90 days once it’s open, or as otherwise required by law. In Missouri, the law that phrase points at is the 60-day decision clock

Separate door: Evernorth Behavioral Health

Aetna

Behavioral health in house, separate form
  • Usually: a request for participation, then a network-need evaluation, then credentialing pulled from CAQH, then contracting. Commonly 60 to 120 days end to end, with recredentialing generally every 36 months
  • Path: behavioral health professionals use the separate behavioral health request for participation, not the medical one, even when joining a medical group
  • Missouri change to know: Aetna left the ACA individual and family marketplace on December 31, 2025 in every state it sold on, Missouri included. So it’s a commercial group and Medicare story here now, not a marketplace one

Cox HealthPlans

Southwest Missouri, and easy to forget
  • Usually: no published turnaround. As a health carrier it sits under the 60-day statutory decision. Confirm with provider services at submission
  • Why it matters: it’s the locally based carrier in the Springfield area. If your practice sits in or near Greene County, this contract does more work than its size suggests
  • Watch: Cox HealthPlans maintains two directories, its own primary service area network and the First Health network for members travelling outside southwest Missouri. Check which one a claim routes through before assuming you’re out of network

Ambetter from Home State Health

Marketplace, underwritten by Celtic
  • Usually: no published Missouri turnaround. The 60-day statutory decision applies. Confirm at submission
  • Path: Ambetter publishes a separate Behavioral Health Join Our Network form alongside the physical health one. Start on the behavioral one
  • Why it’s worth a file: Home State Health also holds the MO HealthNet Managed Care contract and the Show Me Healthy Kids specialty contract, so one Centene relationship in Missouri can reach marketplace, Medicaid and foster care members. Each is still its own contract

Medica

Four Missouri networks, not one
  • Usually: no published Missouri turnaround. Medica’s manual is clear that you aren’t in network until you’ve satisfied credentialing, signed an agreement and been configured in its system. Confirm at submission
  • The thing to check: Medica runs Missouri as four separate regional networks for 2026. Balance by Medica covers southwest Missouri and the St. Louis metro. Medica with MU Health Care covers mid-Missouri counties including Boone, Callaway and Cole. Select by Medica covers the Kansas City side. Medica with SSM Health covers St. Charles, St. Louis City, St. Louis and Warren
  • Watch: being contracted with Medica doesn’t automatically put you in all four. If a Medica card turns up, check which network the product uses before you assume you’re in it

Humana

Medicare Advantage and government lines
  • Usually: Humana publishes a Missouri-specific credentialing page alongside only two other states, which is itself a tell that Missouri’s statute changes how carriers work here. Check the current published Missouri turnaround on that page rather than assuming a national number
  • Scope it deliberately: Humana announced in 2023 that it was exiting employer group commercial medical and phased that out, so a Missouri practice scoping a commercial package shouldn’t count on a Humana group contract
  • Watch: government lines are scoped and priced separately from a commercial package

Two Missouri assumptions have gone stale. Aetna is no longer a marketplace option here, having left the ACA individual and family market on December 31, 2025, so any 2025 checklist listing it for individual coverage is wrong. And Humana is a Medicare conversation in Missouri, not a commercial group one, after its national employer-group exit. Missouri’s 2026 individual market still leaves every county with at least two carriers and most with four or more. Government payers, meaning Medicare and MO HealthNet Managed Care, are scoped and priced separately from a commercial package.

Carry a plan we didn’t list? Add it.

Missouri has a few routes that don’t look like payers. The Missouri Consolidated Health Care Plan is a stand-alone state entity with its own board covering state employees, retirees and many public entities, and you reach those members through Anthem’s network rather than by contracting with MCHCP. Kansas City and St. Louis building trades funds and UFCW-affiliated Taft-Hartley trusts are usually reached by joining a rented commercial network rather than the fund itself. The First Health network is how a Cox HealthPlans member outside southwest Missouri reaches you. And a large share of Missouri employer coverage is self-funded with the carrier providing administrative services only, so the network contract gets you there while the plan’s own prior authorization rules can differ. You name the plan. We find the real route.

What we need from you

Send these once and we can start.

You give us this in one intake. Then we fill out the applications. No passwords, no patient information, and nothing gets submitted until you’ve read it and signed.

  • Your individual NPIPlus a Type 2 if you bill under a group or entity. Missouri plans check both against your MMAC enrollment before they load a Medicaid contract, and Blue KC asks you to confirm your NPPES record is current before you even submit its Network Interest Application.
  • Active Missouri licence and DEAThe DEA certificate has to show your current practice location. Blue KC’s published criteria say so specifically, and an old address on the certificate is a real stall.
  • Your Missouri BNDD certificateBlue KC lists a valid state controlled substance registration alongside the DEA. It’s issued a year at a time and re-applied for annually, so we watch the expiration the same way we watch a licence.
  • CAQH attested and authorizedIn Missouri this isn’t housekeeping. The state adopted the CAQH form as its standard credentialing form by regulation, so an unattested profile blocks every commercial application at once. Carelon asks Missouri behavioral health providers to set access to Global. You attest. We keep it current and never ask for your password.
  • MMAC access, and the right enrollment categoryDelegated access so we can prepare your MMAC enrollment and each plan application, with no password sharing. We also need to know which category fits: billing or performing, MCO network provider, or ordering, prescribing and referring only.
  • Ten years of work historyMonth and year, with any gap over six months explained. Blue KC asks for ten rather than the usual five, so we build the long version once and reuse it everywhere.
  • Malpractice certificateNaming you. Blue KC’s stated minimums are $1,000,000 per claim and $3,000,000 aggregate, plus any state coverage requirement where you practice.
  • Your collaboration agreement, if you’re an APP applying to Blue KCIts published criteria ask you to name an in-network Blue KC provider as collaborating or supervising physician and attach the agreement. We flag it early, because finding an in-network collaborator is not something to start on the day the application is due.
  • Entity name, EIN and W-9One per tax ID. Blue KC contracts to the location and tax ID configuration at the time you sign, so adding a site later means an amendment and possibly more credentialing.
  • Application fee status, if you’re enrolling an organizationMMAC charges an enrollment application fee for institutional providers. Individual practitioners aren’t charged. If you paid it to Medicare or another state’s Medicaid in the last two years you’re exempt, and we need the proof.

Depending on your service mix, Missouri may certify the practice itself, separately from your own licence. The state term is certification by the Missouri Department of Mental Health, Division of Behavioral Health, under the Title 9 certification standards. Missouri certifies organizations rather than individual clinicians, and it ties certification to program type and to public money: the Division says any organization contracting with it must obtain and maintain certification, and certain non-contracted agencies receiving county mental health funds are covered too. It shows up around Community Psychiatric Rehabilitation, Comprehensive Substance Treatment and Rehabilitation, crisis services, residential settings and Certified Community Behavioral Health Organization status. An outpatient prescriber billing commercial plans and MO HealthNet for office visits is a different animal from an agency running a program. Organizations already accredited by CARF, The Joint Commission or the Council on Accreditation can file the shorter accredited-agency application. We ask about it during intake so it doesn’t surface halfway through a payer contract. We don’t give legal advice and we don’t file it for you.

How it works

You answer once. We do the paperwork.

You can buy online without a meeting. Published price, published scope, no call needed unless you want one.

Buy the package

Published price and scope. No call needed.

One intake

Short and guided. It asks more only where your answers call for it.

We prepare everything

The MMAC enrollment in the right category, the plan applications and every commercial file, built from what you told us.

You review and sign

Read it, change anything, sign. Nothing goes out until you say so.

We submit and track

Every purchase includes Command Suite, so you can see where each payer application stands, what we’re working on, what’s waiting on a payer, and what we still need from you.

What we stand behind

Payer decisions, timing and rates are not ours to promise, and we don’t promise them. Our own work is a different matter. If something we delivered does not work the way we said it would, we fix it at no charge for 30 days after delivery, including one stabilization review. A new request, another payer or provider, a change of scope, or a new build is quoted separately. You won’t get an invoice for correcting our mistake.

Built to keep working after we’re done

Everything we set up is built for the practice you are growing into, not only the one you have today. Adding a provider or a second location should be a configuration change rather than a rebuild. When the engagement ends you own the accounts, the documentation and the systems, and they keep running without us. No lock-in.

Questions we get

Missouri credentialing questions

How long does credentialing take in Missouri?
Missouri law gives you the shape. Under RSMo 376.1578 a health carrier has two working days to send a notice of receipt, ten days after that to request anything missing before your application counts as complete, and 60 days from a completed application to approve or deny and tell you. It also has to give you a provider web portal where you can check the status of an electronically submitted application, which most people never ask for. Plan on 60 to 120 days per payer end to end, because contracting and loading sit outside the decision. Files that disclose substance use or behavioral disorders, licensure discipline, revoked or restricted hospital privileges, or malpractice judgments are carved out of the 60-day clock by design.
Will a Missouri carrier pay me for services I delivered while credentialing was pending?
Sometimes, and the condition is the part most summaries skip. Under RSMo 376.1578, once the carrier approves your credentialing it has to pay for covered services you performed during the credentialing period, from the date you submitted a completed application through approval, when those services were delivered through a contracted entity. So a provider joining a clinic that already holds the contract is inside the protection. A solo practice building its first panels usually isn’t, because there’s no contracted entity yet. If you are covered, you get six months after approval to submit those claims and you can’t bill the patient for that period. Hold the claims instead of writing them off, and get a complete application in early rather than waiting for a start date.
Do I need MMAC enrollment if I only want to see managed care patients?
Yes, and there’s no way around it. Federal rule 42 CFR 438.602 has required states to screen and enroll every managed care network provider since January 1, 2018, so a health plan can’t load you if the state hasn’t enrolled you. UnitedHealthcare’s own Missouri Community Plan material says it plainly. Enrollment is Missouri Medicaid Audit and Compliance’s job, not the MO HealthNet Division’s and not the plans’. If you’ll only ever see managed care members there’s a specific application for that, the MCO Network Provider Application, and it’s required rather than optional. MMAC works applications in the order they arrive, so the date you file is the date that matters.
I only write prescriptions and never bill Medicaid. Do I still have to enroll?
Yes. Missouri runs an Ordering, Prescribing and Referring enrollment for exactly that, and it’s a three-document filing: the OPR Questionnaire, the OPR Enrollment Application and the Title XIX Participation Agreement. Without it, ordered, prescribed and referred claims deny, and the person who finds out is your patient at the pharmacy counter. Be clear-eyed about the tradeoff though. MMAC states that an OPR-only provider can’t submit claims to MO HealthNet, so if you might ever bill, enroll as a billing or performing provider instead. Picking the wrong category is the most common way a Missouri Medicaid enrollment gets sent back, and refiling costs you more than choosing carefully did.
Which Blue plan do I apply to in Missouri?
Both, if your patients come from both sides of the state. Missouri has two Blue licensees. Anthem Blue Cross and Blue Shield covers most of Missouri, operating as RightCHOICE Managed Care, Healthy Alliance Life Insurance Company and HMO Missouri. Blue Cross and Blue Shield of Kansas City covers 30 Missouri counties around Kansas City plus Johnson and Wyandotte counties in Kansas. They use different behavioral health vendors too: Anthem routes to Carelon, Blue KC routes to Lucet. Two Blue licensees inside one state is a different thing from needing a contract per state, and BlueCard still carries either contract to Blue members who live elsewhere.
Is Missouri really an any willing provider state?
Optum’s Missouri page says it accepts applications in compliance with that legislation, which is genuinely useful. Read the statute before you lean on it, though. RSMo 376.325 applies to a health carrier that has built a closed or exclusive network, it’s written for a physician licensed under chapter 334, and it conditions acceptance on agreeing to a rate 15 percent below the carrier’s standard prevailing or market fee schedule for that geography. It also doesn’t apply to anyone who fails the carrier’s selection standards and credentialing criteria or who hasn’t signed the standard participating provider agreement. So it’s a narrower tool than the phrase implies, and we wouldn’t build a strategy on it without checking the specific carrier and product first.
Where does an Anthem Missouri behavioral health application go?
Through Carelon Behavioral Health, submitted in the Carelon payer space on Availity, not through Anthem’s medical application. Carelon is Elevance’s behavioral subsidiary and it owns credentialing and recredentialing for Anthem Missouri behavioral health, with the Missouri provider experience contact sitting on the Carelon side. It runs five steps: apply, eligibility review, contract, credential, activate, with recredentialing at least every three years. Carelon also asks you to set your CAQH access to Global so it can see your data. Starting on the medical door is the mistake that costs Missouri prescribers the most time. Blue KC behavioral health goes to Lucet instead, UnitedHealthcare goes to Optum, and Cigna goes to Evernorth.
Do you need my CAQH password?
No, and we won’t ask. We’re added as an authorized practice manager, which lets us keep your practice data current and authorize payers. You complete and attest your own profile, and you sign anything that needs your signature. In Missouri this carries more weight than usual, because CAQH is the state’s credentialing form in regulation. RSMo 354.442 directs the Department of Commerce and Insurance to develop a standard credentialing form all health carriers must use, and 20 CSR 400-7.180 adopts the CAQH Universal Credentialing DataSource form as that standard. One unattested profile stalls every commercial application at once.

Keep reading

Related

Missouri PMHNP scope of practiceWhat Missouri allows you to do, separate from who pays you.
Kansas credentialingKanCare on the Medicaid side, and a Kansas City Blue that crosses the line.
Kentucky credentialingForty-five days, and the insurer has to pay you for the wait.
Tennessee credentialingBack pay exists, but only if you’re joining a contracted group.
Opening your own practiceEntity, identifiers, payers, EHR and billing setup.
Adding a provider to your clinicFirst-time credentialing into contracts you already hold, which is the path Missouri’s back-pay rule actually reaches.
Changing your entity or tax IDMoving panels without breaking the money.

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Where this comes from

  • Missouri Revisor of Statutes, RSMo 376.1578, the credentialing procedure, the 60-day decision, the status portal and payment during the credentialing period verified July 26, 2026
  • Missouri Revisor of Statutes, RSMo 376.325, Missouri’s any willing provider provision and its limits verified July 26, 2026
  • Missouri Code of State Regulations, 20 CSR 400-7.180, adopting the CAQH form as the standard credentialing form verified July 26, 2026
  • Missouri Medicaid Audit and Compliance, provider enrollment categories and eMOMED verified July 26, 2026
  • Missouri Medicaid Audit and Compliance, ordering, prescribing and referring enrollment verified July 26, 2026
  • Missouri Medicaid Audit and Compliance, enrollment of managed care network providers under 42 CFR 438.602 verified July 26, 2026
  • Missouri Code of State Regulations, 13 CSR 65-2.020, revalidation timing and retroactive enrollment verified July 26, 2026
  • Blue Cross and Blue Shield of Kansas City, credentialing and contracting guide and provider minimum criteria verified July 26, 2026
  • Carelon Behavioral Health, Missouri quick reference guide for Anthem commercial and Medicare Advantage verified July 26, 2026

Written by Ryan Berg, founder of AdvanceAPractice. 16 years in healthcare revenue cycle and credentialing.

Facts on this page were verified July 26, 2026 and are next due for review October 26, 2026.

Payer programs, plans and timelines change. Everything here carries a verification date and gets re-checked on a review cycle; this record is next due for review on October 26, 2026. Approval and effective dates are controlled by each payer and by the state, and nothing here promises an approval, a timeline or a rate. This page covers payer operations. It isn’t legal, tax or scope of practice advice.