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Missouri Billing Guide

This Billing Guide outlines Missouri’s workers' compensation billing requirements and DaisyBill’s resources on how to file compliant medical bills.

Billing Form Requirements

This table is a guide to DaisyBill's resources on the required forms for compliant paper and electronic workers’ comp billing in Missouri.

Forms

Services

DaisyBill Resources

CMS-1500*

Physician Services

Laboratory / Pathology

DME

CMS-1500 Instructions

UB-04*

Facility

NCPDP*

Pharmacy

ADA*

Dental

*Not required but recommended by DaisyBill

State-Mandated Physician Reporting Requirements

This table is a guide to DaisyBill's resources on the reporting forms required for compliant paper and electronic workers’ comp billing in Missouri.

Service

Attachment Description

Number of Days until Due

 Form Link

Physician Services

Medical Treatment Form

Not specified

Medical Treatment Form (PDF) 

Electronic Billing Mandate

The Missouri Division of Workers' Compensation has not issued electronic billing regulations or rules for medical bills. Accordingly, contact the payer to determine if workers’ comp bills can be submitted electronically.

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