Home Health for Children: Growth Chart Documentation Requirement

The Missouri MO HealthNet Division (MHD) issued guidance on October 19, 2026, specifying documentation requirements for Home Health services provided to children under age 21. Coverage applies to children with low birth weight (less than five pounds at birth) or failure-to-thrive (defined as abnormal deceleration of the growth process). Eligibility determinations are based on the child's weight-for-height deficit. A child's medical record must include a growth chart tracking both weight and height, with the dates of each observation. MHD recommends use of the National Center for Health Statistics Weight-for-Height graphs, with separate charts for boys and girls, both covering birth to 36 months. The submission mechanism for the growth chart depends on the billing method. Providers submitting paper claims must attach a physical copy of the growth chart to the claim. Providers submitting claims electronically must enter the child's weight and height information directly into the electronic billing portal. MHD directs providers to Section 2.12 and Section 3.3 of the Home Health Provider Manual for further detail on documentation requirements.