From: Travis West, Director of Business Systems Division of Senior and Disability Services
Subject: HCBS Fusion Prior Authorization and Billing Issue
This memorandum serves to notify Home and Community Based Services (HCBS) providers of important information pertaining to Prior Authorizations (PAs) generated in HCBS Fusion since May 5th, 2025.
Due to an issue assigning the correct provider identifier to PAs in HCBS Fusion, providers may find their taxonomy code is inaccurate when attempting to bill for certain Aged and Disabled Waiver services.
Services affected are as follows:
- Chore (S5120)
- Homemaker (S5130)
- Basic Respite (S5150)
- Advanced Respite (S5150 TF)
The Division of Senior and Disability Services (DSDS) recognizes the criticality of this issue and is prioritizing a future update to prevent the issue from recurring.
DSDS has identified affected care plans and will be reauthorizing them to ensure the correct identifier and subsequent taxonomy code are assigned. DSDS will commence the process to fix these PAs once the larger fix is deployed into the system and ensure it is completed as quickly as is possible.
Until DSDS notifies providers of issue resolution, we advise providers to refrain from billing for the affected services. Providers can continue to bill for unaffected services. Once the issue is resolved, providers can bill for the affected services.
We apologize for the inconvenience and appreciate your patience while we remediate the issue. Questions pertaining to this memorandum should be sent to HCBS.Systems@health.mo.gov.
TW