Children and Youth with Special Health Care Needs Providers

As a licensed/certified provider, you are essential to the health and well being of Missourians with special health care needs.

• CYSHCN Service Coordinator Map
• CYSHCN Provider Manual
• CYSHCN Reimbursement Rate Schedule
• Claims Submission Guidelines

The following billing forms should be utilized:

• Health Insurance Claim Form, CMS-1500
• UB-04 (hospitals)
• Dental Claim Form

If you are interested in becoming a provider, contact the SHCN Central Office by phone or in writing to request an application packet or refer to the “New Provider Enrollment, Re-Enrollment and Provider Address Change Information” section below.

New Provider Enrollment and Re-Enrollment Information

Providers must review and complete the Participation Agreement and Provider Application for new enrollment, re-enrollment or when there is a change in their payment mailing address. Additionally, registration is required at MissouriBUYS, powered by MOVERS. In the event of an address change, providers must also update their information in MissouriBUYS, powered by MOVERS. Submit the completed forms via email or mail.

• Children and Youth with Special Health Care Needs Participation Agreement (effective 7/1/2022-6/30/2025)
• Children and Youth with Special Health Care Needs Participation Agreement (effective 7/1/2025-6/30/2028)
• Provider Application (CC-35)
• MissouriBUYS, powered by MOVERS
• Vendor Input/ACH-EFT Application