What services are subject to a copay?

Copays will apply to the following hospital and physician related services: 

Services

Copay Amount

Inpatient Hospital Services

$ 10.00

Outpatient or Emergency Room Services

$   3.00

Physician Services

$   1.00

Clinic Services

$    .50

X-ray and Laboratory Services

$ 1.00

Nurse Practitioner Services

$ 1.00

CRNA Services/Anesthesiologist Assistant

$   .50

Rural Health Clinic Services

$ 2.00

Case Management Services

$ 1.00

Federally Qualified Health Care Services

$ 2.00

Psychology Services

$ 2.00

Non-Emergency Medical Transportation

$ 2.00

For dental, optical and podiatry services, the following copays apply:

If MO HealthNet pays the following amount for a service:

Your Copay Amount

$10.00 or less

$   .50

$10.01 to $25.00

$ 1.00

$25.01 to $50.00

$ 2.00

$50.01 or more

$ 3.00

 

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