table of contents - health.mo.gov · subsection: 6.01 general information page 1 of 2 . ......

Division of Community and Public Health

Section: 6.0 Diagnostic Services Program Revised June 2017

Subsection: 6.00 Table of Contents of 1

Missouri Department of Health and Senior Services Tuberculosis Case Management Manual

Table of Contents

6.0 Diagnostic Services Program

6.1 General Information

6.2 Program Guidelines

6.2.1 Eligibility Requirements

6.2.2 Health Services

6.2.3 Billing Instructions

6.2.4 Participation Agreement for Diagnostic Services Provider

6.3 Procedure Codes and Rates

6.4 Diagnostic Services Program Provider List

Diagnostic Services Program Provider Listing is located in the TB Manual; Appendices/Other Resources at: Tuberculosis Case Management Manual | Health & Senior Services

http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/Appendices.pdf

http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/index.php





Subsection: 6.01 General Information Page 1 of 2


General Information Policy: To provide tuberculosis evaluation services for those without insurance or other

financial barriers to care, who have been identified as infected with or suspected of having tuberculosis.

Purpose: To control and eliminate tuberculosis through a comprehensive system of diagnostic evaluation, appropriate and effective treatment, consultation, technical assistance, and education.

Procedure: 1. The patient is identified by the Local Public Health Agency (LPHA) as being

tuberculin skin test positive, and is not covered by health insurance, or otherbarriers to health care exist preventing the patient from accessing diagnosticmedical evaluation for tuberculosis.

• The Missouri Department of Health and Senior Services (DHSS) TBElimination Program determines eligibility at the request of the LPHA,as funding allows.

2. The LPHA chooses a physician from the Diagnostic Services Providers listlocated in the TB Manual; Appendices/Other Resources at:http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanu al/pdf/Appendices.pdf

3. The LPHA completes the Diagnostic Services Eligibility/AuthorizationForm located at:http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanu al/pdf/Appendices.pdf and faxes the form to the DHSS TBElimination Program for authorization.

• The LPHA should indicate the services requested for the patient,prior to faxing the form to the program.

4. The Diagnostic Services Program Manager assigns a pre-authorizationnumber and indicates which services are approved and faxes the form backto the LPHA.

5. The LPHA schedules an appointment for the patient, faxes a copy of theapproved authorization form to the provider(s), and ensures that appropriatefollow-up takes place.

6. If TB medications are prescribed for the patient, the physician sends a copyof the prescription for the entire prescribed course of medications to theLPHA.






http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/DSPAuthorizationForm.pdf

http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/DSPAuthorizationForm.pdf






Subsection: 6.01 General Information Page 2 of 2


7. The LPHA sends the prescriptions to the DHSS TB Elimination Programstate nurse for authorization of medications to be provided by the TBElimination Program.

8. Upon receipt of the state nurse’s authorization of the medication request,the LPHA faxes the prescription and authorization form to the contractpharmacy.

• The LPHA provides the medications and routine patient monitoringon a monthly basis.

For more information see the TB Manual; Case Management; Disease/ Obtaining Medications located at: http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/Chap4.pdf

9. All bills for services provided through the DSP program are to be mailed tothe Missouri Department of Health and Senior Services, TB EliminationProgram, not to the LPHA.

10. All clinical specimens for diagnostic tests are to be sent to the StatePublic Health Laboratory (SPHL)/TB Unit so that there will be no costsincurred by either the participating physician or the patient.

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http://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/Chap4.pdf





Subsection: 6.02 Program Guidelines Page 1 of 2


Program Guidelines An increased demand for outpatient services for tuberculosis has been experienced by the Local Public Health Agencies (LPHA). One of the shortcomings of public health is the difficulty in accessing care. With the help of the Diagnostic Services Program (DSP), patients with financial barriers to care can seek the diagnosis and treatment they need.

General Program Guidelines: 1. The rate of reimbursement shall be the established rate listed under the service

description at the end of this section.

2. Prior to providing program services, providers shall assure that the client has been authorized to receive services from the Missouri Department of Health and Senior Services (DHSS) TB Elimination Program. DHSS will not reimburse providers for services that are provided prior to authorization.

3. Prior to the LPHA making an appointment with a DSP provider, the LPHA must request authorization from the DHSS TB Elimination Program. The LPHA provides the following information in the request:

a) Patient’s name b) Date of birth c) Social Security Number d) Telephone number e) Address

4. All providers may submit bills on any standard invoice or billing form. The procedure codes and pre-authorization number listed on the Diagnostic Services Eligibility/Authorization form must be included. Providers shall not submit results of the lab work, progress notes, or any other type of medical information. Bills should be submitted to:

Missouri Department of Health and Senior Services TB Elimination Program P.O. Box 570 Jefferson City, MO 65102

5. The DHSS will not make payment for any items or services to the extent that payment

has been made, or can reasonably be expected to be made, under any state compensation program, including Medicaid or Medicare, under an insurance policy,



Subsection: 6.02 Program Guidelines Page 2 of 2


under any federal or state health benefits program, or by an entity that provides health services on a prepaid basis. DHSS is unable to pay the co-pay portion or deductible portion of any public or private compensation programs in which the patient is enrolled.

6. DHSS has the authority to review patient records and provider billings to assure that program guidelines as written herewith are followed.

7. The program shall be conducted in accordance with all state and federal nondiscrimination requirements. The standards for eligibility and participation in this program shall be the same for all regardless of race, creed, color, national origin, handicap, sexual orientation, or gender.

8. DHSS reserves the right to limit or deny services to clients in order to adhere to budgetary limitations of the program.

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Subsection: 6.02.1 Eligibility Requirements Page 1 of 1


Eligibility Requirements

Purpose: To ensure proper identification of patients who are eligible for services under the Diagnostic Services Program (DSP).

Procedure:

1. The Missouri Department of Health and Senior Services (DHSS) TB Elimination Program determines eligibility at the request of the local public health agency (LPHA). • The patient is identified by the Local Public Health Agency (LPHA) as

being tuberculin skin test positive, and is uninsured or underinsured by health insurance, or other barriers to health care exist preventing the patient from accessing diagnostic medical evaluation for tuberculosis.

2. The LPHA shall complete a Diagnostic Services Eligibility/Authorization Form and fax it to the TB program prior to scheduling any services for the patient. • All requests for DSP services must be in writing, verbal authorization will

not be provided.

3. To be eligible for services: • The patient must not have the ability to obtain the services from any other

public or private health insurance program. • This program will not cover the deductible portion of any insurance

program and. • Services are not available to residents of penal institutions, however,

services are available to eligible parolees and those who have completed their sentence.

• Confidentiality of names and identifying characteristics will be carefully guarded and only given to the provider of services.

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https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/DSPAuthorizationForm.pdf



Subsection: 6.02.2 Health Services Page 1 of 2


Health Services:

Services provided under the DSP, as funding allows, include office visits, Clinical procedures, chest z-rays, and chest x-ray interpretation.

1. Office Visits and Diagnostic Services

a. Participating physicians must hold a current license with the Missouri Board of Healing Arts and must have a current participation agreement with the Missouri Department of Health and Senior Services.

b. Reimbursement amounts for diagnostic tests will be the established state rate:

• Initial Office Visit - $100

• Subsequent office visit (SOV) - $70 per visit (maximum of eight SOV)

• Chest x-ray (CXR) - $75

• Chest x-ray interpretation - $36

• Induced sputum collections - $10.83 per collection (maximum of six collections)

c. Authorizations for diagnostic tests are made under the procedure codes listed on the last page of this subsection. Invoices should be submitted using the specific code for the test.

d. The total allowable amount per patient will be $836:

Service Maximum allowed

Price per unit of service

Total

Initial office visit 1 $100 $100

Subsequent office visit 8 $70 $560

Chest x-ray 1 $75 $75

X-ray interpretation 1 $36 $36

Induced sputum collection 6 $10.83 $65

Total allowable per patient $836

• Subsequent office visits (SOVs) will be authorized after initial office visit and physician determines the need for follow up.



Subsection: 6.02.2 Health Services Page 2 of 2


• SOVs will be authorized in increments of two visits per request, until the maximum allowable eight visits have been used.

e. Participating physicians must be willing to provide office visits for diagnosis of tuberculosis, and must have prior arrangements for patient chest x-rays.

f. Physicians must also be willing to order induced sputum collection for patients who cannot produce sputum on their own, and clinical proof of sputum conversion is needed.

Diagnostic Services Program Provider Listing is located in the TB Manual; Appendices/Sample Forms at: Tuberculosis Case Management Manual | Health & Senior Services.

2. Physician Ordered Treatments:

Treatment of tuberculosis and tuberculosis infection in adults and children is to be in accordance with the American Thoracic Society (ATS), the Centers for Disease Control and Prevention (CDC) and Infection Disease Society of America (IDSA) recommended regiments as endorsed by the Missouri Department of Health and Senior Services, TB Elimination Program.

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https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/Chap6.pdf#page=15

https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/index.php

https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/index.php



Subsection: 6.02.3 Billing Instructions Page 1 of 2


Billing Instructions for DSP Providers

Patients may not be charged a co-payment for authorized services

1. Prior Authorizations

a. Upon identification of a patient that may qualify for assistance through the Diagnostic Services Program (DSP), the LPHA will fax the Diagnostic Services Eligibility/Authorization form to the TB Elimination Program’s DSP Manager. A pre-authorization number will be assigned and the signed authorization form will be returned to the LPHA as referenced on page 1, in Subsection 6.02.1.

b. Providers will not be reimbursed for services that were provided to a client prior to receiving authorization for the service from the DSP

c. Prior authorization will list services authorized per client. The initial authorization will be for one chest x-ray, one interpretation, and the initial office visit. A second authorization is required prior to provision of subsequent TB diagnostic services.

d. Prior authorization questions should be addressed to the DSP Manager at (573) 526-5832.

2. Invoice Forms

a. Invoice(s) may be submitted on any facility standard bill form. Include patient’s name(s), procedure code, and the authorization number.

b. Invoices must show the specific date of service and number of services delivered on that date.

c. All invoices for services provided to approved patients must be submitted to: Missouri Department of Health and Senior Services (DHSS) TB Elimination Program] PO Box 570 Jefferson City, MO 65102

no later than 60 days following the date of service

d. Final invoices for services must be submitted no later than January 31, of the following year.

e. Questions regarding how to submit invoices should be directed to the DSP Manager





Subsection: 6.02.3 Billing Instructions Page 2 of 2


3. Denial of Payment

a. Services will be paid only if prior authorization for the services has been authorized by the DSP.

b. The decision to pay an invoice received is based on information taken from the written prior authorization. If a service is denied for payment, completely or partially, a denial letter will be bent to the provider.\

c. Failure to invoice within 60 days following the date of service will result in denial of payment.

d. Questions regarding authorization or billing may be addressed to the DSP Manager at (573) 526-5832.

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Subsection: 6.02.4 Participation Agreement for Diagnostic Services Provider Page 1 of 2


Participation Agreement for Diagnostic Services Provider

All participating providers must have a current Diagnostic Services Program (DSP) agreement with the Missouri Department of Health and Senior Services (DHSS) before participating in the DSP.

The provider’s printed name, name of authorized representative, signature of provider or representative with date, social security or federal tax identification number, payment mailing address, state license number, telephone number, and primary contact person’s email address must be completed on all participation agreements. In addition, providers who are not already registered as a vendor should register in the MissouriBUYS system. Failure to complete the registration process will result in delay of payment for invoices received from unregistered vendors.

1. Log on to the MissouriBUYS webpage at: https://missouribuys.mo.gov/vendors/index.html

• Under the Registration Help tab, locate the vendor registration checklist and ensure all required information is readily available to complete the registration process.

• Vendor registration instructions are also available under the Registration Help tab.

• Questions regarding technical difficulties with the webpage should be directed to the helpdesk listed under the Contacts tab.

• Complete the Vendor Input/ACH-EFT application, and fax it to (573) 526-9813 or mail to:

Office of Administration/Accounting PO Box 809 Jefferson City, MO 65102

All copies of the signed participation agreement should be submitted to the DSP Manager either by faxing the signed agreement to (573) 526-0234 or mailing it to:

Missouri Department of Health and Senior Services TB Elimination Program PO Box 570 Jefferson City, MO 65102-0570

After approval by DHSS, a copy of the fully executed agreement will be sent to the provider.

https://missouribuys.mo.gov/vendors/index.html



Subsection: 6.02.4 Participation Agreement for Diagnostic Services Provider Page 2 of 2


Provider Monitoring

The DSP has the right to monitor providers with current DSP agreements. The provider will be contacted by phone in order to schedule a date for a review. A list of client records that will be reviewed will be included with a follow up letter which will be mailed within 5 business days of the scheduling phone call.

Follow up visits may be indicated if problems are identified that require corrective action. Questions regarding provider monitoring reviews may be addressed to the DSP manager.

Records will be reviewed for:

1. Prior authorization of services;

2. Physician orders, when indicated;

3. Services were delivered within the date range stated on the prior authorization;

4. Billed services match delivery dates of services;

5. Services delivered coincide with services billed.

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Subsection: 6.03 Procedure Codes and Rates Page 1 of 1


Health Procedure Codes and Rates

SERVICE

PROCEDURE CODE

RATE

MAXIMUM ALLOWED

Office Visit:

Office Visit (Initial) 99205 $100/Visit 1 Office Visit (Subsequent) 99215 $70/Visit 8

Clinical Procedures:

Induced Sputum Collection 89220 $10.83/specimen 6

X-ray:

Chest, Posterior-Anterior and Lateral View

71020

$75

1

Interpretation 71020A $36 1

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Subsection: 6.04 Diagnostic Services Provider List Page 1 of 9


ADAIR COUNTY

ANDREW COUNTY

ATCHISON COUNTY

AUDRAIN COUNTY

BARRY COUNTY Cox Monett Hospital 901 N. Lincoln Ave Monett, MO 65708 Phone: (417) 235-3144

X-Ray Pediatrics

BARTON COUNTY

BATES COUNTY

BENTON COUNTY Golden Valley Medical -Warsaw Clinic 1771 Commercial Street Warsaw, MO 65355 Phone: (660) 438-5193 Fax: (660) 438-3091

X-Ray Pediatrics

Katy Trail Community Heath Warsaw Clinic 17571 N. Dam Access Rd Warsaw, MO 65355 Phone: (877) 733-5824

Pediatrics

BOLLINGER COUNTY Cross Trails Medical Center 109 Highway 51 North Marble Hill, MO 63764 Phone: (573) 238-2725 Fax: (573-238-2725

X-Ray Pediatrics

BOONE COUNTY Columbia Radiology Imaging Services Dba Advanced Radiology of Columbia 311 Keene Street Columbia, MO 65205 Phone: (573) 442-1788

X-Ray Pediatrics

Columbia/Boone County Department of Public Health and Human Services 1005 W. Worley St. Columbia, MO 65203 Phone: (573) 874-7345

BUCHANAN COUNTY Southside Health Center Northwest Health Services, Inc. 5001 Lake Avenue St. Joseph, MO 64504 Phone: (816) 238-7788

X-Ray Pediatrics

North End Health Center Northwest Health Services, Inc. 1515 St. Joseph Avenue St. Joseph, MO 64505 Phone: (816) 233-3338

X-Ray Pediatrics

Social Welfare Board Dr. James McMillen 904 S. 10th, Suite A St. Joseph, MO 64503 Phone: (816) 233-5188 Fax: (816) 233-5296

Mosaic Life Care 901 Heartland Road, Suite 4840 St. Joseph, MO 64506 Phone: (816) 271-1346

X-Rays





BUTLER COUNTY Missouri Highlands Medical Clinic 225 Physicians Park Dr., Suite 303 Poplar Bluff, MO 63901 Phone: (573) 785-6536

Pediatrics

Westwood Medical Clinic 1919 Big Bend Road Poplar Bluff, MO 63901-2813 Phone: (573) 686-7223

Kneibert Clinic 686 Lester Street Poplar Bluff, MO 63901 Phone: (573) 6868-8452

Pediatrics

CALDWELL COUNTY Braymer Clinic 109 Main Braymer, MO 64624 Phone: (660) 645-2218

Hamilton Medical Clinic One Cross Street Hamilton, MO 64644 Phone: (816) 583-2151

X-Ray Pediatrics

CALLAWAY COUNTY Community Health Center of Central Missouri 561 Commons Drive Fulton, MO 65251 Phone: 573-632-2777

Pediatrics

CAMDEN COUNTY Lake Regional Clinic 1930 North State Hwy 5, Unit 1A Camdenton, MO 65020 Phone: (573) 346-5624 *NOTE* Sees only Camden County pts.

X-Ray Pediatrics

CAPE GIRARDEAU COUNTY Cape Girardeau County Public Health 1121 Linden Street Cape Girardeau, M 63702 Phone: (573) 335-7846

Pediatrics

Cross Trails Medical Center 408 S. Broadview St. Cape Girardeau, MO 63703 Phone: (573) 332-0808

Pediatrics

CARROLL COUNTY

CARTER COUNTY Big Springs Medical Clinic 405 Main St. Van Buren, MO 63965 Phone: (573) 323-4253

X-Ray Pediatrics

CASS COUNTY

CEDAR COUNTY Cedar County Memorial Hospital and Medical Mall Clinic 1401 S. Park St. El Dorado Springs, MO 64744 Phone: (417) 876-2511

CCMH Medical Mall Clinic 1317 S. Hwy 32 El Dorado Springs, MO 64744 Phone: (417) 876-5477

CHARITON COUNTY

CHRISTIAN COUNTY





CLAY COUNTY Samuel U Rodgers Health Center 800 Euclid Avenue Kansas City, MO 64124 Phone: (816) 889-4600 Ask for Jody Light to schedule appts.

X-Ray Pediatrics

CLARK COUNTY

CLINTON COUNTY

DOUGLAS COUNTY

COLE COUNTY Community Health Center of Central Missouri 3400 W. Truman Blvd. Jefferson City, MO 65109 Phone: (573) 632-2777

Pediatrics

Advanced Radiology of Jefferson City, LLC 3218 W. Edgewood Jefferson City, MO 65109 Phone: (573) 635-6262

X-Ray Pediatrics

Community Health Center of Central Missouri 104 Gerhart Rd California, MO 65018 Phone: 573-632-2777

Capital Region Physicians- Internal Medicine Lorenzo McKnelly, DO Gracia Nabhane, MD 1125 Madison Street Jefferson City, MO 65101 Phone: (573) 634-2620

X-Rays

COOPER COUNTY

CRAWFORD COUNTY

DADE COUNTY

DALLAS COUNTY

DUNKLIN COUNTY

DAVIES COUNTY

DEKALB COUNTY

DENT COUNTY

FRANKLIN COUNTY Mercy Clinic – Pulmonology 901 Patients First Drive Washington, MO 63090 Phone: (636) 239-8832

X-Ray Pediatrics

GASCONADE COUNTY

GENTRY COUNTY King City Clinic 305 Rhode Island King City, MO 64463 Phone: (660) 535-4347

GREENE COUNTY

GRUNDY COUNTY

HARRISON COUNTY Cainsville Medical Clinic Northwest Health Services 707 Victory Lane Cainsville, MO 64632 Phone: (660) 893-5750

HENRY COUNTY Golden Valley Medical Clinic 1602 North 2nd

Street Clinton, MO 64735 Phone: (660) 890-8429

X-Ray Pediatrics HICKORY COUNTY





HOLT COUNTY Mound City Medical Clinic Northwest Health Services 502 State Street Mound City MO 64470 Phone: (660) 442-5464 X-Ray Pediatrics

Oregon Clinic Northwest Health Services 401 E. Nodaway Oregon, MO 64473 Phone: (660) 446-3307

Pediatrics

HOWARD COUNTY

HOWELL COUNTY Ozarks Medical Center 1100 Kentucky Atene West Plains, MO 65775 Phone: (471) 256-9111

X-Ray Pediatrics

McVicker Family Health Care Ozarks Medical Center 220 N. Elm St. Mt. View, MO 65548 Phone: (417) 934-2273

Pediatrics

OMC Urgent Care Ozarks Medical Center 181 Kentucky Avenue Highland Park, Suite 100 West Plains, MO 65775 Phone: (417) 257-5911

X-Rays Pediatrics

West Plains Imaging of Ozarks Medical Center 3102 Independence Dr. West Plains, MO 65775 Phone: (417) 257-7451

X-Ray Pediatrics

HOWELL COUNTY CONT. Westwood Rural Health Clinic Angela Poole, NP 2646 State Route 76 Willow Springs, MO 65793 Phone: (417) 469-5124 Fax: (417) 469-1165

Pediatrics

IRON COUNTY Annapolis Family Clinic Missouri Highlands Health Care 202 Allen St. Annapolis, MO 63620 Phone: (573) 598-4213

Pediatrics

Iron County Medical Clinic Missouri Highlands Health Care 315 W. Mulberry Pilot Knob, MO 63663 Phone: (573) 546-0602

Pediatrics

Viburnum Medical Clinic Missouri Highlands Health Care 18 Viburnum Center Rd Viburnum, MO 65566 Phone: (573) 244-5406

X-Ray Pediatrics

JACKSON COUNTY Truman Medical Center Lakewood Community and Family Medicine 7900 Lees Summit Road Kansas City, MO 64139 Phone: (816) 404-7678

X-Ray Pediatrics

JASPER COUNTY Jasper County Health Department 105 Lincoln Street Carthage, MO 64836 Phone: (417) 358-3111





JEFFERSON COUNTY Jefferson County Health Department 405 Main Street Hillsboro, MO 63050 Phone: (636) 282-1010

X-Ray Pediatrics

JOHNSON COUNTY

KNOX COUNTY

LACLEDE COUNTY

LAFAYETTE COUNTY

LAWRENCE COUNTY Mt. Vernon Clinic 1011 S. East Street Mt. Vernon, MO 65712 Phone: (417) 466-7191

Pediatrics

LEWIS COUNTY Quincy Medical Group 105 Quincy Lewistown, MO 63452 Phone: (573) 215-2715

X-Ray Pediatrics

LINCOLN COUNTY

LINN COUNTY

LIVINGSTON COUNTY

MADISON COUNTY Madison Medical Center 611 West Main Street Fredericktown, MO 63645 Phone: (573) 783-3341

X-Ray Pediatrics

MARIES COUNTY

MARION COUNTY Hannibal Regional Hospital 6000 Hospital Dr. Hannibal, MO 63401 Phone: (573) 248-1300

X-Ray Pediatrics

MARION COUNTY CONT Hannibal Regional Medical Group 6500 Hospital Drive Hannibal, MO 63401 Phone: (573) 248-1300

X-Ray Pediatrics

MCDONALD COUNTY OCH Anderson Rural Health Clinic Ozarks Community Hospital 104 E. Main Street Anderson, MO 64831 Phone: (417) 845-6984

Pediatrics

OCH Goodman Family Clinic Ozarks Community Hospital 135 Roy Hill Blvd Goodman, MO 64843 Phone: (417) 364-8300

Pediatrics

OCH Southwest City Community Clinic Ozarks Community Hospital 109 N. Broadway Southwest City, MO 64863 Phone: (417) 762-3287

Pediatrics MCDONALD COUNTY OCH Pineville Medical Clinic Ozarks Community Hospital 5265 S. Business Hwy 7, Suite J Pineville, MO 64856-0265 Phone: (417) 223-4290

Pediatrics





MERCER COUNTY

MILLER COUNTY Iberia Medical Benny Earl Thomas, D.O. Highway 17 North Iberia, MO 65486 Phone: (573) 793-2591

X-Ray Pediatrics

MISSISSIPPI COUNTY

MONITEAU COUNTY

MONROE COUNTY

MONTGOMERY COUNTY Associated Medical Arts 504 North Sturgeon Street Montgomery City, MO 63361 Phone: (573) 564-2990

Pediatrics

MORGAN COUNTY Prairie Hills Community Health Katy Trail Community Health 1109 Clay Versailles, MO 65084 Phone: (573) 378-2351

Pediatrics

NODAWAY COUNTY

NEW MADRID COUNTY

NEWTON COUNTY

OREGON COUNTY Alton Medical Clinic Ozark Medical Center 100 Medical Dr. Alton, MO 65606 Phone: (417) 778-7227

X-Ray Pediatrics

OREGON COUNTY CONT Thayer Medical Clinic Ozarks Medical Center 300 Warmfork Road Thayer, Mo 65791 Phone: (417) 264-7136

X-Ray Pediatrics

OSAGE COUNTY Community Health Center of Central Missouri 1016 E. Main St. Linn, MO 65051 Phone (573) 632-2777

Pediatrics

OZARK COUNTY Gainesville Medical Clinic Ozarks Medical Center 37 Medical Dr. Gainesville, MO 65655 Phone: (417) 679-4613

X-Ray Pediatrics

PEMISCOT COUNTY

PERRY COUNTY Cross Trails Medical Center 1314 Brenda Avenue Perryville, MO 63775 Phone: (573) 517-0405

Pediatrics

PETTIS COUNTY Sedalia Imaging Center 1430 Thompson Blvd., #7 Sedalia, MO 65301 Phone: (660) 851-0758 X-Ray Pediatrics

Katy Trail Community Health 821 Westwood Sedalia, MO 65301 Phone: (660) 826-4774

Pediatrics





PHELPS COUNTY Rolla Family Clinic 1060 S. Bishop Ave Rolla, MO 65401 Phone: (573) 426-5900

X-Ray Pediatrics

PIKE COUNTY PCMH Clinic 2305 Georgia Louisiana, MO 63353 Phone: (573) 754-4584

X-Ray Pediatrics

PLATTE COUNTY Platte County Health Department 212 Marshall Road Platte City, MO 64079 Phone: (816) 858-2412

POLK COUNTY Citizens Memorial Hospital 1500 N. Oakland Bolivar, MO 65613 Phone: (417) 326-6000

X-Ray Pediatrics

Polk County Health Department 1317 West Broadway Bolivar, MO 65613 Phone: (417) 326-7250

Pediatrics PULASKI COUNTY Crocker Medical Center Benny Earl Thomas, D.O. 103 Commercial Crocker, MO 65452 Phone: (573) 736-2422

X-Ray Pediatrics

Thomas Medical Center Benny Earl Thomas, D.O. 215 North Street Waynesville, MO 65583 Phone: (573) 774-6279

X-Ray Pediatrics

PUTNAM COUNTY

RALLS COUNTY

RANDOLPH COUNTY

RAY COUNTY

REYNOLDS COUNTY Ellington Family Clinic Missouri Highlands Health Care 61 Hwy Y Ellington, MO 63638 Phone: (573) 663-2525

X-Ray Pediatrics

RIPLEY COUNTY Naylor Medical Clinic 220 E. Broad St. Naylor, MO 63953 Phone: (573) 399-2311

X-Ray Pediatrics

SALINE COUNTY Saline County Health Department 1825 S. Atchison Avenue Marshall, MO 65340 Phone: (660) 886-3434

Grand River Medical Clinic 815 E. Broadway Brunswick, MO 65236 Phone: (660) 886-7800

Katy Trail Community Health 1825 Atchison Ave. Marshall, MO 65340 Phone: (877) 733-5824

SCHUYLER COUNTY

SCOTLAND COUNTY

SCOTT COUNTY Missouri Delta Medical Center 1008 North Main Sikeston, MO 63801 Phone: (573) 471-1600

X-Ray Pediatrics





SHANNON COUNTY Shannon County Family Clinic Missouri Highlands Health Care 1003 S. Main St. Eminence, MO 65466 Phone: (573) 226-5505

X-Ray Pediatrics

Shannon County Medical Clinic Ozarks Medical Center 1008 N. Highway 19 Winona, MO 65588 Phone: (573) 325-4237

X-Ray Pediatrics

SHELBY COUNTY

ST. CHARLES COUNTY Midwest Chest Consultants, P.C. 330 First Capitol Drive, Suite 470 St. Charles, MO 63301 Phone: (636) 946-1650

X-Ray ST. CLAIR COUNTY

ST. FRANCOIS COUNTY Mineral Area Pain Center 608 Maple Valley Drive Farmington, MO 63640 Phone: (573) 756-3400

X-Ray

Parkland Health Center 1101 W. Liberty St Farmington, MO 63640 Phone: (573) 756-6451

X-Ray Pediatrics

ST. LOUIS COUNTY Berland Imaging 774 N. New Ballas Road St. Louis, MO 63141 Phone: (314) 567-1656

STE GENEVIEVE COUNTY Ste. Genevieve County Memorial Hospital 800 Ste. Genevieve Dr. Ste. Genevieve, MO 63670 Phone: (573) 883-2751

X-Ray Pediatrics

STODDARD COUNTY Cross Trails Medical Center 307 Gabriel St. Advance, MO 63730 Phone: (573) 722-3034

X-Ray Pediatrics

STONE COUNTY

SULLIVAN COUNTY SCMH Milan Family Practice Clinic 212 East Second Street Milan, MO 63556 Phone: (660) 265-4456 SCMH Green City Clinic 18 W. 3rd St. Green City, MO 63545 Phone: (660) 874-5887

Sullivan County Memorial Hospital Physician’s Clinic 630 West 3rd street Milan, MO 63556 Phone: (660) 265-5204

TANEY COUNTY Bridges Medical Clinic 265 State Highway H Forsyth, MO 65653 Phone: (417) 546-4200





TANEY COUNTY CONT Branson Walk in Clinic 1440 State Hwy 248, Suite J Branson, MO 65616 Phone: (417) 239-0706

Cox Health Medical Center-Branson 890 State Highway 248 Branson, MO 65616 Phone: (417) 335-2299

Pediatrics

Lakes Region Imaging 251 Skaggs Rd Branson, MO 65616 Phone: (417) 335-7733

X-Ray

Cox Health Family Medicine Hwy 248 1150 State Highway 248

WEBSTER COUNTY Jordan Valley Community Health Center – Marshfield 1166 Banning Street Marshfield, MO 65706 Phone: (417) 831-0150

Pediatrics

WORTH COUNTY

WRIGHT COUNTY Mountain Grove Medical Complex Ozarks Medical Center 500 E. 19th St. Mountain Grove, MO 65711 Phone: (417) 926-6563

X-Ray Pediatrics

Branson, MO 65616 Phone: (417) 348-8964

Pediatrics

TEXAS COUNTY

VERNON COUNTY

WASHINGTON COUNTY

WAYNE COUNTY

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