This page includes news and resources for providers enrolled to serve Minnesota Health Care Programs (MHCP) members. News articles are retained on the Minnesota Department of Human Services (DHS) website for one year. Current messages are linked below. Sign up to receive provider news and other MHCP notices through our free provider email lists.
Systems announcements
We will update this section with information about MN–ITS availability, technical information and other systems announcements when necessary.
Minnesota Department of Human Services (DHS), in partnership with several state agencies, will host the second annual Minnesota Autism Resource Symposium on Wednesday, April 12, 2023, to support Autism Acceptance Month. The theme for the virtual event is “Partners in progress” to promote finding solutions, bridging gaps and advocating change.
Accommodations: American Sign Language (ASL) and Communication Access Realtime Translation (CART) provided. Use the Autism Contact Form to request other accommodations by Friday, March 31, 2023.
Background
The symposium is a joint effort by several state agencies to promote health, use of coordinated supports, education and resiliency in the state’s autism community.
The symposium partnership includes:
DHS
Minnesota Department of Education (MDE)
Minnesota Department of Health (MDH)
Minnesota Department of Employment and Economic Development (DEED)
University of Minnesota Institute on Community Integration (ICI).
The Centers for Medicare & Medicaid Services released the 2023 Clinical Laboratory Fee Schedule files Jan. 4, 2023. Minnesota Health Care Programs reprocessed affected laboratory claims received with dates of service on or after Jan. 1, 2023. The reprocessed claims appeared on your Feb. 14, 2023, remittance advice. (pub. 3/21/23)
The new Kepro website provides all dental prior authorization questionnaire forms. Minnesota Health Care Programs (MHCP) removed links to the forms in the MHCP Provider Manual and replaced them with links to the Kepro website. (3/20/23)
On November 28, 2022, the Behavioral Health division sent a Behavioral Health Fund billing clarifications for SUD services in Minnesota jails e-Memo. The e-Memo explained that the major program code OO (Behavioral Health Fund) covers SUD services for incarcerated individuals. However, we notified providers that claims for incarcerated individuals receiving SUD services were not paying when Medical Assistances (MA) and managed care organization (MCO) coverage overlapped with major program OO.
The Minnesota Department of Human Services (DHS) reprocessed SUD providers’ denied claims for incarcerated individuals with major program OO coverage that overlapped with MA and MCO coverage for dates of service from January 1, 2021, through January 31, 2023. The reprocessed payment for the claims that were denied will appear on the remittance advice statement for March 14, 2023.
If you have further questions, contact the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411. (pub. 3/17/23)
Minnesota Department of Human Services is offering an online webinar training for mental health and home and community-based services (HCBS) providers on completing revalidation using the online MPSE portal. These trainings will provide a live demonstration about how to complete revalidation using MPSE. There are two training sessions available for each group and each group’s sessions will be tailored to their provider type, otherwise all the information will be the same:
U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra notified states that the federal COVID-19 PHE will end on May 11, 2023, in a Letter to U.S. Governors renewing COVID-19 Public Health Emergency (PHE). We will continue to communicate policy updates as this unfolds. (pub. 3/14/23)
Minnesota Department of Human Services (DHS) received notification from the federal government that the federal public health emergency will end on May 11, 2023. Temporary waivers in place for Housing Stabilization Services providers during the federal public health emergency end May 11, 2023, and will be replaced by policy requirements.
Housing Stabilization Services federal public health emergency waivers ending May 11, 2023
Conflict of interest requirements that allowed Housing Stabilization providers to offer both the assessment or person-centered plan and Transition or Sustaining services to the same person.
Person-centered plan physical signature requirements, but verbal signatures are still required.
Remote support limitations.
Housing Stabilization Services policy requirements resuming May 12, 2023
Housing Stabilization providers cannot provide both the assessment or person-centered plan and Transition or Sustaining services to the same person unless there is an approved exception in place.
The provider agency who delivered the assessment or plan is allowed to continue to provide Transition or Sustaining services to the same person until the person's annual renewal or if the person decides to change their Transition or Sustaining provider agency.
The provider agency must come into compliance with conflict of interest requirements at the person’s annual renewal.
All person-centered plans must contain signatures of the person supported as well as the planner and ongoing Housing Stabilization Services provider selected.
Electronic signatures are allowed for the Housing Focused Person-Centered Plan, however, a provider cannot sign on behalf of a person seeking services or another agency.
Remote support state plan limitations and requirements.
The Minnesota Department of Human Services is reprocessing previously denied dental claims submitted for members who are dually enrolled in Medicare Part B and Medical Assistance. Your reprocessed claim will appear on your warrant and remittance advice for March 14, 2023.
Some dental providers resubmitted previously denied claims and may have already been paid.
Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 3/14/23)
The Minnesota Department of Human Services (DHS) has created new, secure online forms for lead agencies and providers to submit the following Service Agreement and Screening Document (SASD) forms in place of sending them via fax:
We are in the final stages of updating our MN–ITS system to send a copy of the Home Care Technical Change Request (DHS-4074) or the PCA Technical Change Request (DHS-4074A) to the provider agency’s MN–ITS mailbox after a provider submits the forms to DHS. The copy will appear in the “Miscellaneous Received” section in the PRVLTR folder in MN–ITS. We will send out another Provider news when this process is finalized.
We are changing prior authorization (PA) request policy for incontinence products effective July 1, 2023. You will need PA for any incontinence product, or combination of incontinence products, of more than 400 units per month provided to a member. All existing PAs expire June 30, 2023, and you must request a new PA, if needed, effective July 1, 2023. (pub. 3/9/23)
The Minnesota Department of Human Services EVV team offers quarterly webinar sessions to providers required to use EVV. The webinars clarify roles and responsibilities and review recent updates and next steps. The sessions are scheduled from 1 to 2 p.m. for the following dates:
The American Medical Association discontinued prolonged services CPT code 99354 on Jan. 1, 2023. We used the procedure code to report prolonged psychotherapy services provided face to face with the member. You can bill two units of 90837 for prolonged psychotherapy services provided face to face with the member for 91 minutes or more effective Jan. 1, 2023. (pub. 3/6/23)
For Targeted Case Management (TCM) providers, the TCM waiver (CV-24) allowing both phone and interactive video to meet minimum face-to-face contacts is allowed through end of day on May 11, 2023, as outlined in Bulletin 21-69-04C and in the COVID-19 section of the Minnesota Health Care Programs Provider Manual.
New Interactive Video (ITV) standards go into effect May 12, 2023
Some of the temporary waiver modifications made during the PHE will become permanent according to Minnesota Statutes 256B.0625, subdivision 20(c) and 20b. Specifically, providers can now choose ITV to meet minimum face-to-face contact requirements when applicable within each statute for targeted case management.
Assurance statement
You must have a Targeted Case Management Provider Interactive Video Assurance Statement on file with the Minnesota Department of Human Services (DHS) if you choose to have ITV as a reimbursed medical assistance option for these services:
Child Welfare Targeted Case Management (CW-TCM)
Children’s Mental Health Targeted Case Management (CMH-TCM)
Adult Mental Health Targeted Case Management (AMH-TCM)
Vulnerable Adult/Developmental Disability Targeted Case Management (VA/DD-TCM)
We will update you when this assurance statement becomes available in the coming weeks. Attestation requires compliance with the ITV requirements outlined in Minnesota Statutes 256B.0625, subdivision 20b, as well as policies and procedures regarding the safety and effectiveness of providing TCM services through ITV.
Bulletin
We will provide further guidance on new TCM ITV standards in an official DHS bulletin before the standards effective date of May 12, 2023. (pub. 3/2/23)
We have revised the family member types listed in this message to specify parents of minors and stepparents of minors. During the COVID-19 federal public health emergency, personal care assistance (PCA) agencies were temporarily allowed to hire the following types of family members to be paid to provide PCA services to individuals enrolled in Minnesota Health Care Programs (MHCP):
Parents of minors
Stepparents of minors
Spouses
Legal guardians of minors
The federal government has announced that they are ending the public health emergency on May 11, 2023.
What this means for PCA agencies and family members who have been providing PCA services:
After May 11, 2023, PCA agencies can no longer pay the family members previously listed to provide PCA services to members enrolled in MHCP to receive PCA care.
MHCP is directing PCA agencies and families to work together with the lead agency (county, tribal government, or managed care organization) to develop an alternative plan for providing PCA services.
PCA agencies who have additional questions can contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 or use the Disability Services Division Contact Form to submit an inquiry. (pub. 2/28/23, rev. 3/6/23)
Minnesota Department of Human Services is using knowledge gained from the first two EVV launches to help develop policies and guidance to ensure providers are able to meet EVV compliance requirements. Providers of services that have launched for in-scope EVV services need to complete the EVV onboarding process and begin using their EVV system now.
We know providers, caregivers and members need time to onboard to the EVV system they selected and that it will take time for EVV to become routine. We are not enforcing compliance that will result in claim denials or reversals in 2023. We will monitor EVV usage and utilization until we publish compliance requirements to ensure you are prepared before being required to meet the compliance requirements. We are required to report quarterly usage to the Centers for Medicare & Medicaid Services to identify providers not using an EVV system. We will provide technical assistance to providers identified in the reports as we move towards compliance requirements. We will publish a timeline of compliance thresholds for providers on the Electronic visit verification webpage in advance of the effective date for compliance requirements to help providers meet compliance requirements.
Click the Affected services tab on the Electronic visit verification webpage to review which services are in-scope for EVV. Click the Contact us tab to find contact information. (pub. 2/27/23)
Minnesota Health Care Programs (MHCP) will offer a free resources and MN–ITS training to show enrolled MHCP providers how to bill for enhanced asthma care services.
The training will be held on March 16, 2023, from 2 to 3:30 p.m. via webinar only. Registration is now open. Register for the training at Enhanced Asthma Care services MN–ITS Billing. (pub. 2/23/23)
Minnesota Health Care Programs (MHCP) recently implemented the April 1, 2019, Centers for Medicare and Medicaid Services (CMS) revision for outpatient APC conditional processing for laboratory procedures status indicator Q4.
Claims billed with a status indicator of Q4 and any of the following status indicators were overpaid in error:
Q1
Q3
S
2
T
3
V
MHCP reprocessed the claims with dates of service on January 1, 2020, through January 12, 2023, to correct the overpayment. Providers should expect to see these payment corrections on their February 14, 2023, remittance advice. (pub. 2/17/23)
The AMA discontinued prolonged services CPT codes 99354, 99355, 99356, and 99357 effective Jan. 1, 2023. CPT code range 99354 – 99357 were face-to-face prolonged care codes that could be used with office or outpatient codes or inpatient, observation or nursing facility services. Add-on codes to bill for prolonged services currently do not exist. You may still provide these services, but are unable to bill for them due to the AMA discontinuing these codes. We are working on alternative ways for you to bill and be paid for these services and we will update you when we have a solution. (pub. 2/14/23)
Minnesota Department of Human Services completed system programming for modifier 93 for EIDBI telehealth claims. Modifier 93 indicates “Audio only: Synchronous telehealth service rendered via telephone or other real-time interactive audio-only telecommunications system.” MHCP requires this modifier when audio-only telehealth is used.
We reprocessed previously denied telehealth claims for EIDBI providers that included modifier 93. The reprocessed claims will appear on your Feb. 14, 2023, remittance advice. As a reminder, individual EIDBI providers must have an approved Telehealth Provider Assurance Statement (DHS-6806) (PDF) on their provider file beginning June 1, 2022, to bill claims for services provided via telehealth. You must submit claims for dates of service beginning June 1, 2022, as soon as possible.
Review the EIDBI telehealth services webpage and the Telehealth Services section of the Minnesota Health Care Programs Provider Manual for more information and billing instructions. (pub. 2/8/23)
Minnesota Department of Human Services (DHS) has temporarily suspended authorization thresholds or service limitations for medical assistance fee-for-service claims for psychotherapy effective Jan. 1, 2023. We are temporarily suspending service limitations to help us understand utilization of these psychotherapy services. Providers do not have to submit authorization requests for members between Jan. 1, 2023, and Dec. 31, 2024, for hours or units of service exceeding the following:
26 hours psychotherapy (with patient, including biofeedback) per calendar year, cumulative (CPT codes 90832, 90834, 90837, 90875, 90876)
26 units of family psychotherapy (with patient or family member or both), per calendar year, cumulative (CPT codes 90846, 90847)
10 sessions of multiple family group psychotherapy per calendar year (CPT code 90849)
52 sessions of group psychotherapy per calendar year, cumulative (CPT code 90853)
These forms are required, along with other enrollment documents, when a provider is requesting to enroll an Individual PCA or needs to update an individual PCA’s enrollment record.
Starting on April 1, 2023, MHCP will no longer accept the prior version of the above forms. The new versions have a date of 02-21 or newer in the upper right corner and can be signed electronically.
You can also find these forms by using the search function on the Searchable document library (eDocs) webpage. If you have further questions, contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411. (pub. 2/7/2023)
Minnesota Health Care Programs (MHCP) posted a Provider News message on October 25, 2022, about the category of service edit occurring for the following COVID-19 vaccines and administration codes:
Vaccine 91304
administration codes 0041A and 0042A
Vaccine 91308
administration codes 0081A, 0082A and 0083A
Vaccine 91311
administration codes 0111A, 0112A and 0113A
Vaccine 91307
administration codes 0071A, 0072A, 0073A, and 0074A
The category of service edit is now fixed. We reprocessed claims back to the effective dates for the covered codes included in this message.
Find the effective dates for the covered codes on the MHCP fee schedule webpage or under Vaccines in the Billing section under Coronavirus (COVID-19) in the MHCP Provider Manual. (pub. 1/31/23)
Continue following existing COVID-19 policies and procedures for Minnesota Health Care Programs until further notice. We will provide more guidance as it becomes available. (pub. 1/25/23)
A series of clinical trainings will be held in 2023 for Early Intensive Developmental and Behavioral Intervention (EIDBI) providers and other interested provider types. Refer to the following dates, times, topics and learning objectives for each session.
Wednesday, January 18, 2023, noon to 1 p.m.: Evaluation, treatment planning and care coordination
Differentiate between covered and noncovered services for the Comprehensive multi-disciplinary evaluation, treatment plan and coordinated care conference
Define the roles and responsibilities of EIDBI providers implementing these services
Continuing Education Unit (CEU) information
Continuing education credits will be offered for Board Certified Behavior Analysts (BCBAs) through the Minnesota Northland Association for Behavior Analysis (MNABA). All courses will be worth one credit unless otherwise noted. Link to access the CEUs is found under the Agenda section of the registration webpage. Certificates of participation will also be offered for others upon request to submit to their licensure or certification boards. (pub. 1/18/23)
We are aware of the telehealth claims errors that are occurring for services provided via telehealth. We are still currently working on a system fix. Watch for a future Provider News message on this webpage for billing instructions after we complete the system update. (pub. 10/25/22)
Beginning with claims paid on or after Oct. 1, 2022, coinciding with the beginning of the federal fiscal year until the end of the federal fiscal year 2023 (Sept. 30, 2023), regular FMAP increases from 50.51% to 50.79% (1905(b) of Social Security Act).
Since Jan. 1, 2020, until the end of the quarter the COVID-19 federal public health emergency ends, the Families First Coronavirus Response Act (Public Law No. 116-127, section 6008) provides a temporary increase of 6.2% in the FMAP rate for the following services for children, parents or guardians with children under 19, individuals 65 and older and individuals blind or disabled:
Individualized Education Program
Rule 5 Children’s Residential includes Institutions for Mental Disease, which receives an increase in state funds equal to the federal fund increase.
County-provided Targeted Case Management services (Child Welfare, Mental Health and Vulnerable Adult-Developmental Disability)
The 6.2% COVID-19 FMAP increase and the Federal Fiscal Year FMAP increase to 50.79% does not apply to adults without children whose eligibility was gained under the Affordable Care Act and some other populations already receiving an enhanced FMAP.
Counties and providers do not need to do anything to receive the increased FMAP. Claims paid from Oct. 11, 2022, until the end of the quarter the COVID-19 federal public health emergency has ended (defined by federal government) will be paid at the higher 56.99% rate. If the COVID-19 federal public health emergency ends before Sept. 30, 2023, the percentage paid will be 50.79%.
Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 10/11/22)
The Minnesota Transformation Initiative (MTI) in collaboration with the Minnesota Organization for Habilitation and Rehabilitation (MOHR) will hold quarterly trainings focused on organizational transformation to support community engagement and competitive employment. These trainings are free and open to any employment and day service provider in Minnesota.
Webinars will be held on the following dates from 1 - 2:30 p.m.:
Feb. 16, 2023
May 18, 2023
Aug. 17, 2023
Nov. 16, 2023
Feb. 15, 2024
Planned training topics include:
Setting a vision and defining success for transformation
Managing through change (including supporting staff, clarifying roles, identifying professional development, and communication with staff)
Financial stability and sustainability
Moving from center-based to community-based services
Employer engagement
Each session will include perspectives and special considerations for rural providers.
Registration for each quarterly webinar will be sent through the Minnesota Department of Human Services (DHS) Employment First email list. Sign up to receive the email by visiting and scrolling to the bottom of the Employment First webpage. Trainings will be recorded, and recordings will be sent to all who register.
The Minnesota Transformation Initiative is a project funded by (DHS) to support the transition of people with disabilities receiving subminimum wages into competitive, integrated employment. Email Danielle Mahoehney at mahoe001@umn.edu for more information about MTI project activities. (pub. 10/6/22)
We made an update on Sept. 27 to the web platform that houses the MHCP Provider Manual and it caused some formatting and spacing issues, as well as other unexpected behavior, on some provider manual webpages. We are aware of the issue and we are working to get it resolved as soon as possible. (pub. 9/30/22)
Training
Minnesota Health Care Programs (MHCP) offers free training for MHCP enrolled providers.
Minnesota Health Care Programs (MHCP) offers SBCS provider training to MHCP-enrolled schools who wish to provide and bill for SBCS. MHCP provides training through an online webinar. Refer to the SBCS Provider Training and MN–ITS Billing Lab webpage for more information and registration. (pub. 3/24/23)
The Minnesota Department of Human Services (DHS) will be offering monthly live demonstrations of various functions in the MPSE Portal. Live demonstrations take place on the first Wednesday of each month from 1 to 3 p.m. starting on Sept 7, 2022. There will be three categories of live demonstrations provided on a rotating basis. These live demonstrations are free of charge.
Categories of live demonstrations include:
New Provider Enrollment
How to enroll in MPSE as a first-time provider
Shows the steps for enrollment from registration to submission
Managing Enrollment Records
How to enroll new locations
How to update services, credentials, addresses, and other enrollment information
Managing Affiliations
How to affiliate an individual provider to an organization
How to affiliate an organization to an individual provider
How to affiliate an organization to a direct support worker
How to affiliate a trading partner
Who should attend?
Owners of MHCP-enrolled organizations or individual providers
Employees of MHCP-enrolled organizations who maintain provider enrollment records
Employees of MHCP-enrolled organizations who process affiliations
Employees of MHCP-enrolled organizations responsible for MHCP compliance
Anyone interested in learning more about the MPSE portal
Register for these demonstrations on the MPSE portal training webpage where you can also find on-demand videos and links to more information about the MPSE portal. (pub. 8/18/22)
MHCP offers training for providers who provide services for members enrolled in MHCP. We have updated on-demand and online training opportunities on the MHCP provider training webpage.
On-demand videos
On-demand videos are arranged by category, including Minnesota Provider Screening and Enrollment Portal (MPSE), MN–ITS and Billing. Each video can be viewed in 10 minutes or less and provides instructions on a concept or technique.
Online training
Online training is arranged by content for all providers or specific providers. Training is led by an instructor who will help attendees navigate the Minnesota Department of Human Services website and locate and use MHCP provider information and other related webpages or internet-based applications such as MN–ITS. All instructor-led training is online only. (pub. 11/22/22)
Minnesota Health Care Programs (MHCP) offers free online training for MHCP-enrolled providers. Go to the MHCP provider training webpage to review the list of available training. We have added an Equipment and Supplies training session and have updated training dates for 2023 for all of the following:
Child and Teen Checkups
Chiropractic Services
Dental
Early Intensive Developmental and Behavioral Intervention
Equipment and Supplies
Federally qualified health centers and rural health clinics
Minnesota Health Care Programs (MHCP) is offering free online Provider Basics Resources and MN–ITS training to all enrolled MHCP providers who bill fee-for-services claims. This training is being offered monthly beginning Mar. 10, 2021.
You will learn how to navigate the MHCP provider webpages and the MHCP provider manual, and how to use MN–ITS administration, mailbox and eligibility requests (270/271) features. Go to the Provider Basics webpage to register for this training.
Claim training is not provided in this training. See our MHCP provider training webpage to register for provider-specific claim training. (pub. 2/11/21)
Minnesota Health Care Programs (MHCP) offers free on-demand training videos arranged by category on the MHCP provider training webpage. Each video can be viewed in 10 minutes or less and provides instructions on a concept or technique.
New videos:
Adding an Organization to Individual Provider Affiliation in MPSE – This video demonstrates how an organization adds an affiliation to an individual provider who is already registered with MPSE and has an active enrollment status with the Minnesota Health Care Programs, or MHCP.
Revalidation for MHCP Providers – In this video, we explain what revalidation is, how MHCP notifies enrolled providers that they need to revalidate and where they would find information on how to revalidate.
Managing Services and Credentials in MPSE – In this video, we demonstrate how a provider manages their services and credentials in an active enrollment record. A provider would do this anytime a service is added.
Managing Addresses in MPSE – We demonstrate how an organization or individual provider manages or adds an address in an active enrollment record in this video.
Minnesota Health Care Programs is providing free online training for our MPSE online portal.
See the MPSE portal training webpage for registration, brief online tutorials to help prepare you for class and more information. (pub. 2/1/20, rev. 2/19/20, 7/27/22)
