MCCY/MCAW ME Code Resource | Missouri Department of Health and Senior Services

Medically Complex Children & Youth (MCCY) And Medically Complex Adult Waiver (MCAW) Program Medicaid Eligibility (ME) Codes


This resource is intended to capture MCCY & MCAW Eligible ME Codes, not all ME Codes. Please see the Department of Social Services (DSS) Medicaid Eligibility Codes for additional detail on all ME Codes. If a referral is received for MCCY/MCAW and you are unsure of program eligibility upon ME Code review, based on the table, please consult with your supervisor.
MEDICAID (FEE-FOR-SERVICE)		ELIGIBLE PROGRAM
ME CODE	ME CODE DESCRIPTION	MCCY	MCAW
E2	Adult Expansion Group (does not cover waivered services)	X
01	Old Age Assistance		X
03	Aid to the Blind	X	X
04	Permanently and Totally Disabled	X	X
11	MO HealthNet – Old Age Assistance		X
12	MO HealthNet Aid to the Blind	X	X
13	MO HealthNet – Permanently and Totally Disabled	X	X
14	Supplemental Nursing Care – Old Age Assistance
15	Supplemental Nursing Care – Aid to the Blind
16	Supplemental Nursing Care – Permanently and Totally Disabled
23	MO HealthNet for Kids in Vendor Institution
28	Department of Mental Health – Foster Care
30	Juvenile Courts – Foster Care
33	MO Children with Developmental Disabilities (MOCDD) – DMH Match	X
34	MO Children with Developmental Disabilities (MOCDD) – DSS Match	X
41	MO HealthNet for Kids in Vendor Institution – Poverty
49	Department of Mental Health – Poverty
55	Qualified Medicare Beneficiary (QMB)
67	Department of Mental Health – Foster Care – Health Initiative Fund
69	Juvenile Courts – Health Initiative Fund
70	Juvenile Courts – Poverty
80	Extended Women’s Health Services
81	Temporary Assignment Category
83	Breast or Cervical Cancer Control Project – Presumptive	X
84	Breast or Cervical Cancer Control Project – Regular	X	X
85	Ticket to Work Health Assurance	X	X
86	Ticket to Work Health Assurance	X	X
87	Presumptive Eligibility Children
89	Uninsured Women’s Health Services (state funded)
TEMPORARY ASSISTANCE – FEE-FOR-SERVICE
58	Presumptive Eligibility (Subsidized)
59	Presumptive Eligibility (Non-Subsidized)
88	Voluntary Placement Agreement (Fee-for-service only)
STATE FUNDED MEDICAL ASSISTANCE – FEE-FOR-SERVICE
State funded ME Codes do NOT cover waivered services
02	Blind Pension (State Funded)	X
64	Group Home – Health Initiative Fund (State Placement) (State Funded)
65	Group Home – Health Initiative Fund (Parent/Guardian Placement) (State Funded)
MANAGED CARE (MC)		ELIGIBLE PROGRAM
Individuals enrolled in a Special Health Care Needs (SHCN) Program have the option to ‘opt out’ of their MC plan for straight Medicaid (fee-for-service). If this option is selected, there will be an ‘opt out’ noted in their MHN record. The individual then has fee-for-service MHN coverage and would qualify for MCCY/MCAW Medicaid eligibility. If an ‘opt out’ is NOT noted, the individual has MC and is NOT eligible for MCCY/MCAW.
ME CODE	ME CODE DESCRIPTION	MCCY	MCAW
05	MO HealthNet for Families – Adult	X
06	MO HealthNet for Families – Child	X
07	Foster Care – Title IV-E
18	MO HealthNet for Pregnant Women	X	X
29	Division of Youth Services – Foster Care
36	Adoption Subsidy – Federal Financial Participation	X
37	Title XIX – Homeless, Dependent, Neglected	X	X
38	Independent Foster Care Children Ages 18-26	X	X
40	MO HealthNet – Poverty	X
4M	MO HealthNet for Kids 110+ - 153% Poverty, Age 6-18	X
43	Pregnant Woman – Post Partum (MO HealthNet for Families Criteria)	X	X
44	Pregnant Women – Post Partum – Poverty	X	X
45	Pregnant Woman – Poverty	X	X
50	Division of Youth Services – Poverty
56	Adoption Subsidy – Title IV-E	X
60	Newborn	X
61	MO HealthNet for Pregnant Women – Health Initiative Fund	X	X
62	MO HealthNet – Health Initiative Fund	X
6S	SMHB Newborn with Income <196% FPL	X
66	Foster Care – Homeless, Dependent, Neglected (HDN) – Health Initiative Fund
68	Division of Youth Foster Care – Health Initiative Fund
71	MO HealthNet for Kids – 148+ to 150% Poverty, Ae 1-5 (no premium)	X
72	MO HealthNet for Kids – 148+ to 150% Poverty, Age 6-18 (no premium)	X
73	Children Aged 1-18; family income 150+ to 185% (with premium)	X
74	Children Aged 0-18; family income 185+ to 225% (with premium)	X
75	Children Aged 0-18; family income 225+ to 300% (with premium)	X
95	SMHB Pregnant Women Income Above 201% and up to 305%	X	X
96	SMHB Unborn Child with income 0 to 305% FPL
97	SMHB – Newborns Age 0-1; family income 196+ to 300% (no premium)	X	X
9S	SMHB – Newborn with Income 196+ to 300% (no premium)	X	X
98	SMHB Post Partum
STATE FUNDED MEDICAL ASSISTANCE – MANAGED CARE
08	Child Welfare Services – Foster Care (State Funded)	X
0F	Foster Care – IMD Placement (State Funded)	X
52	Division of Youth Services – General Revenue (State Funded)	X
57	Child Welfare Services – Foster Care – Adoption Subsidy (State Funded)	X
5A	Adoption Sub-Guardianship IMD Placement (State Funded)	X