The files below are in xdoc format and xslx format and are only compatible with MS Word 2007 or newer and Excel 2007 or newer respectively. Libre Office and Open Office equivalence may also be used.


Provider TypeExcel Provider TypeExcel
Ambulance xlsx  Optical Services xlsx
Anesthesia - Certified Registered Nurse Anesthetist / Anesthesiologist Assistant xlsx  Other Medical xlsx
Anesthesia - General xlsx  Other Services xlsx
Anesthesia - Supervision of Anesthetists xlsx  Outpatient Hospital xlsx
C-STAR xlsx  Podiatry xlsx
Community Psychiatric Rehabilitation xlsx  Radiology - Professional and Technical Component X-Ray / Nuclear Medicine / EEG / EKG xlsx
Dental Services xlsx  Radiology - Professional Component: X-Ray / Nuclear Medicine / EEG / EKG xlsx
DME Purchase xlsx  Radiology - Technical Component: X-Ray / Nuclear Medicine / EEG / EKG xlsx
DME Rental xlsx  Rehabilitation Center xlsx
DME Repair xlsx  Surgery - Assistant Surgery xlsx
EPSDT Other Services xlsx  Surgery - Postoperative Services xlsx
Hearing Aid and Audiology Services xlsx  Surgery - Without Postoperative Services xlsx
Independent Lab - Professional and Technical Component xlsx  Surgery and Epidurals xlsx
Independent Lab - Professional Component xlsx  Hospitals 2021xlsx
Independent Lab - Technical Component xlsx  Hospitals 2022xlsx
Medical Services xlsx  Hospitals 2023xlsx
Nurse/Midwife xlsx  Hospitals 2024xlsx
MO HealthNet Price Key - All Above Files
Prior Authorization Key - All Above Files

Provider Files Updated 04/09/2024