What Missouri requires
Jan 7, 2026
Soft launch: remittances began carrying N363 alerts on claims that failed EVV matching, while still paying them.
Source: MO HealthNet Hot Tips
Apr 1, 2026
Hard denials for dates of service on or after this date, for provider types 26 and 28 (personal care, advanced personal care, consumer-directed services, homemaker, chore, respite). The first affected remittance check was April 24, 2026.
Source: MO HealthNet DSDS EVV policy
Coming waves
Provider types 58 (home health) and 85 (DD services) are queued for EVV claim matching, with dates to be announced.
Source: MO HealthNet announcements
Regulation
13 CSR 70-3.320 requires EVV vendors to transmit to the aggregator at least daily, and providers to log into the EAS at least weekly.
Source: Missouri Code of State Regulations
Edit-rate / usage rule
Missouri publishes no numeric edit ceiling. Its rule is procedural and blunt: do not bill until the visit is visible in the EAS aggregator in VERIFIED status.
The five match elements
Missouri matches every claim against the EVV visit on five elements: the participant's DCN, the date of service, the Provider Medicaid ID, the procedure code with modifiers, and the units. Fail any one and the claim denies.
Missouri names its mismatch categories rather than publishing numeric edit codes (those are still unpublished): Provider ID mismatches, Participant DCN mismatches, Unmatched Units, and 'Verified visit not found for procedure + date range.'
The race condition is the main event
MO HealthNet's own guidance attributes the majority of issues to claims billed before the visit was verified in the EAS — a pure timing race between your billing cycle and your EVV pipeline. A hold-until-Verified billing gate eliminates the entire class: no claim goes out until its visit shows Verified in the aggregator.
The weekly-EAS-login requirement in 13 CSR 70-3.320 exists for the same reason: agencies that never look at the aggregator discover match failures on remittances instead of dashboards, weeks later and at full denial cost.
What are Missouri EVV denials costing you?
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