The Commissioner of Health has approved the Home Care Provider Advisory Council, established through Minnesota Statutes, 144A.4799, to provide funding to home care providers and other entities to mitigate social isolation of vulnerable adults residing in home care provider settings.
The Home Care Provider Advisory Council will provide grants of up to $2,500 for each provider or entity selected, up to $100,000 total. Providers must use the funds for devices to assist with virtual visits designated for both health care and social isolation. Providers may also use the funds for assistance with improving Wi-Fi or assisting with training and staffing for use of the devices purchased.
The application period begins Jan. 18, 2021, and will remain open for 30 days, or until the allocated money has been awarded, whichever comes first.
How to apply for the grants
Fill out the following application to apply for the grants.
Social Isolation Grant Funding Application for Home Care Provider or Other Entity (PDF)
Email completed applications to the Home Care and Assisted Living inbox at email@example.com. The Home Care Advisory Council will notify you via the email address you provide on the application if you are selected. (pub. 1/21/21)
The HCPCS labor code K0739 billing programming issue was resolved on Jan. 25, 2021. You should resume billing K0739 as per policy and stop using the NU modifier. We will reprocess any claims that were denied and have not yet been resubmitted. (pub. 1/26/21)
HCPCS labor code K0739 billing has been temporarily affected by a programming issue. Claims submitted with K0739 are not processing unless a modifier is attached. Add modifier NU to K0739 when billing so your claim will be paid. This is a temporary billing change. We are working to resolve the issue and will update this webpage when it has been resolved and you can resume billing without using the NU modifier. If you had a claim deny, resubmit your claim using the NU modifier. If you had a claim deny that is linked to a prior authorization request, contact KEPRO to have modifier NU added to your prior authorization first, and then re-submit your claim. (pub. 1/21/21)
Specific residential settings licensed by the Minnesota Department of Human Services have responsibilities when a person or staff member tests positive for COVID-19, including:
For step-by-step instructions and a list of applicable residential settings, see the Provider instructions to complete COVID-19 risk assessment Aging and Adult Services and Disability Services divisions’ eList announcement. (pub. 1/20/21)
The Housing Stabilization Services Eligibility Request System (DHS-7948) will be updated by the end of January 2021. An update allowing the eligibility start date to become the date of submission was made on Jan. 1, 2021. These updates are based on feedback we have received from Housing Stabilization Services providers and include:
Providers must submit eligibility requests with all required assessment documentation and a person-centered plan. See the Allowed Documentation for Housing Stabilization Services Eligibility Requests (PDF) or the new Helpful Tips for Housing Stabilization Eligibility Requests (PDF) for more information about submitting requests. (pub. 1/15/21)
HHS Secretary Alex M. Azar again renewed the COVID-19 public health emergency effective Jan. 21, 2021. See the HSS’ Renewal of Determination That A Public Health Emergency Exists webpage to read the official declaration of this renewal. (pub. 1/13/21)
The American Medical Association approved new coronavirus vaccine Current Procedural Terminology (CPT) codes 91300 and 91301 and the corresponding administration codes for each vaccine. Minnesota Health Care Programs (MHCP) will only reimburse for the administration of vaccines. As a reminder, vaccines are exempt from cost-sharing. Use the following CPT and administration codes to report the administration of the coronavirus vaccines:
You may now submit claims. MHCP will cover administration codes 0001A and 0002A for procedure code 91300 retroactive to dates of service on or after Dec. 11, 2020. MHCP will cover administration codes 0011A and 0012A for procedure code 91301 retroactive to dates of service on or after Dec. 18, 2020.
The covered codes can be found on the MHCP fee schedule webpage. COVID-19 vaccine billing instructions can be found under Billing in the Coronavirus (COVID-19) section of the MHCP Provider Manual. (pub. 1/13/21, rev. 1/20/21)
The redesigned Waivers and Modifications webpage lists the changes to Minnesota Health Care Programs (MHCP) during the COVID-19 pandemic in an interactive format.
You can now sort the list by waiver title, waiver number, executive order number, topic, posted date and expiration date. You can see details about changes to MHCP health care requirements, the authority under which the changes were enacted, the effective date of changes, and the anticipated end date for the program modifications.
This redesign allows you to sort through the list and immediately find the information relevant to you. It will also be an easier tool to use to track when waivers and modifications are ending.
We will continue to update the Waivers and Modifications webpage with new changes and approvals. (pub. 1/7/21)
Minnesota Department of Human Services implemented a 15% residential rate increase on Dec. 23, 2020, for residential SUD treatment services delivered to fee-for-service Medical Assistance (MA) members through the 1115 SUD System Reform Demonstration project.
Eligible residential providers who have enrolled and been approved in the 1115 SUD System Reform Demonstration can submit claims to include the 15% residential rate increase for date of services on or after Dec. 23, 2020.
To receive the 15% residential rate increase for residential treatment services delivered to MA members for services provided on or after Dec. 23, 2020, do the following:
Members must be on major program MA, NM or EH to qualify for the enhanced rate.
Members not in major program MA, NM or EH do not get the 15% residential rate increase.
When billing using MN–ITS
When billing using Batch
For more information about the rate increase and enrolling in the 1115 SUD System Reform Demonstration, refer to the previous provider news message 1115 Substance Use Disorder (SUD) System Reform Demonstration residential rate increases 15%, eligible providers encouraged to enroll.
See the 1115 Substance Use Disorder (SUD) System Reform Demonstration webpage for more information or email firstname.lastname@example.org if you have questions about the demonstration project. (pub. 1/7/21)
Children’s mobile crisis services may be provided in an emergency room or urgent care setting effective Aug. 1, 2020. This change aligns with adult mobile crisis services. See Article 2, section 24 of the State of Minnesota House of Representatives H.F. No. 11 (PDF) for more information.
Children’s crisis providers can submit fee for service and managed care claims for services provided in an emergency room or urgent care setting retroactive to Aug. 1, 2020.
Crisis assessment, intervention and stabilization services provided in a hospital emergency room or urgent care outpatient hospital setting for children must follow covered service standards. See the Children's Mental Health Crisis Response Services section of the Minnesota Health Care Programs Provider Manual for more information. (pub. 1/5/21)
Two updates to billing under the EIDBI benefit are effective Jan. 1, 2021.
The Department of Human Services (DHS) is contracted with Syrtis Solutions to act as an e-prescribing intermediary with Surescripts® for formulary, medication history and member eligibility inquiries. The contract with Syrtis Solutions expires on Dec. 31, 2020, and DHS has been unsuccessful in securing a new contract with Syrtis Solutions or a replacement vendor.
As of Jan. 1, 2021, DHS will no longer be supported in offering these services through Surescripts.® We will still offer the online Minnesota Medicaid Fee-For-Service Pharmacy Program Drug Search, which also contains drug coverage information by major program and date of service.
Note: information provided by the drug search tool does not guarantee coverage or payment from Minnesota Health Care Programs. Real-time claim submission provides the most accurate member enrollment, drug coverage, member responsibility and provider reimbursement information. (pub. 12/30/20)
The 2019 Minnesota Legislature enacted a law creating new licensing requirements for assisted living in Minnesota.
The assisted living licensure requirements go into effect Aug. 1, 2021, and apply to:
See the Minnesota Department of Health’s (MDH) Assisted Living Licensure in Minnesota: Frequently Asked Questions (PDF) for exemptions, next steps and additional resources.
MDH has opened a public comment period and encourages the public to submit written comments on the proposed rules for the Assisted Living Licensure. The public comment period will end Jan. 13, 2021. See the Assisted Living Licensure webpage for the proposed rules for the Assisted Living Licensure, the Notice of Hearing, the Statement of Need and Reasonableness (SONAR) and instructions on how to submit written comments. (pub. 12/30/20)
Recent legislation in Minnesota allows for a temporary 8.4% increase for direct support workers to respond to COVID-19. The Department of Human Services (DHS) temporarily will increase rates for Personal Care Assistance (PCA) and increase the budgets by 8.4% for Consumer Directed Community Supports (CDCS) and Consumer Support Grants (CSG).
This increase was federally approved for Dec. 1, 2020, through Feb. 7, 2021.
Our system was updated to reflect the increase on Friday, Dec. 11, 2020. Claims processed after Dec. 18, 2020, will reflect the 8.4% increase. DHS will replace claims that were billed prior to programming completion. The rate increase will not be applied to supervision of PCA services.
With the additional funds the provider or provider agency must:
The legislation requires that all applicable service providers must develop and implement a distribution plan that includes the details about how the provider will use the increased funds in a way that complies with the statute. Impacted providers were previously notified of the requirement to submit their distribution plans by Dec. 20, 2020.
For more information on the legislation and requirements to implement this increase, see:
The Minnesota Department of Human Services (DHS) has made its initial study on the expanded use of telemedicine during the COVID-19 peacetime emergency available on our Telemedicine review webpage.
When the pandemic began, many Minnesotans delayed getting needed heath care, including mental health care and substance use disorder treatment, due to concerns about COVID-19. A number of state and federal laws and rules also limited the use of telemedicine for Medicaid-funded services and that resulted in services delivered via telemedicine being unavailable to many people who needed care the most. Therefore, DHS worked to secure waivers for these laws and rules to allow the expansion of telemedicine in Minnesota.
We took the opportunity to review the utilization of telemedicine during the pandemic. The study found:
The report recommends:
Providers can use MN–ITS to access data about an affiliated worker’s completion of qualifying training to make a member’s services eligible for the enhanced rate or budget. Personal care provider organization agencies and financial management services providers can see if an affiliated worker has completed the qualifying training, the date the worker qualified and the date the worker’s qualification expires. This can help the provider receive accurate reimbursement payments.
Steps to view data in MN–ITS:
The data will open in Excel format with columns F, G and H used to show the enhanced rate data.
If you notice enhanced rate training data is not showing for your staff but the staff have reported taking the course to be qualified, submit Individual DSW Information Change Form (DHS-5716) (PDF). Check the box titled “DSW completed the Qualified Enhanced Rate training” and fill in the training completion date and training expiration date (if applicable).
A Provider Eligibility and Compliance specialist will review the form, confirm with a DHS policy specialist, and, if applicable, add to the record. You will not receive a confirmation notice after the record has been updated. Confirmation will be done using the Excel spreadsheet on MN–ITS. If inaccurate data is submitted or if we need additional information, a Request for Resubmission notice will be sent to the MN–ITS mailbox of the agency that submitted the form.
See the Enhanced rates or budgets and training stipends for support workers and instructions for eligible people with qualified workers on the Provider agency/FMS provider requirements for enhanced rate or budget webpages for more information. (pub. 12/22/20)
People, lead agencies and other provider types use the Minnesota Health Care Programs (MHCP) Provider Directory and the Minnesotahelp.info directory to locate service providers in Minnesota. Your contact information is automatically added to these directories when you receive approval to be an MHCP-enrolled EIDBI provider and it is critical to keep your information updated to ensure efficient access to services.
Updating individual contact information
Complete and submit the Individual Practitioner - MHCP Provider Profile Change Form (DHS-3535) (PDF). Use this form to report changes of individual provider names, addresses, ending or adding affiliation to an agency and so on.
Updating agency contact information
Complete and submit the Organization – MHCP Provider Profile Change Form (DHS-3535A) (PDF). Use this form to report you are no longer providing EIDBI services, changes in affiliated providers, addresses and so on.
Updating Minnesotahelp.info profile
Update or add information to your Minnesotahelp.info profile via chat or e-mail through the Minnesotahelp.info Provider Portal. You can add details such as your company website, insurance coverage you accept, counties you serve, treatment methods you provide and your current intake capacity. (pub. 12.22/20)
The Minnesota Department of Human Services’ commissioner has approved a waiver that temporarily allows students to receive Individualized Education Program (IEP) Personal Care Assistance (PCA) services identified in the students’ IEP or Individualized Family Service Plan (IFSP) in their home during the COVID-19 health emergency. This waiver, effective Nov. 12, 2020, was announced in Bulletin #20-56-13 Support for family caregivers and distance learning. This waiver is intended to help support the child during distance learning.
Schools must follow the same requirements outlined in the Individualized Education Program (IEP) Personal Care Assistance (PCA) Services section of the MHCP Provider Manual to be reimbursed for IEP PCA services in a child’s home.
Schools should contact the Minnesota Department of Education for guidance about determining in-school and in-home PCA services.
This modification is not a policy change, but a change to allow schools to bill for the place of service in the home. Continue to use place of service as school on your claims, but document that the PCA service was provided in the home until our system changes are complete. We will announce when the system changes are complete.
Once our system changes are complete, schools will be required to replace the claims that used place of service as school and documented that the service was provided in the home to reflect the correct place of service on the claim. It is up to each school to determine what is best for their school. Schools may want to hold off billing to avoid having to replace claims at a later date. Another option would be to keep a log of claims for children that received services in the home but had place of service listed as school so that those claims can be replaced once our system is updated.
Call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411 if you have questions about this message.
MHCP does not cover educational supports or tasks.
This waiver will remain in effect until 60 days after the end of the state’s COVID-19 peacetime emergency. (pub. 12/21/20)
Minnesota Department of Human Services (DHS) received Centers for Medicare & Medicaid Services (CMS) approval for a 15% rate increase for residential services in the 1115 SUD System Reform Demonstration. Minnesota Health Care Programs (MHCP) will provide information on this webpage about reprocessing claims when it becomes available. Eligible residential providers interested in enrolling in the 1115 SUD System Reform Demonstration are encouraged to enroll before June 30, 2021. Residential provider enrollment applications approved by the federally required ASAM compliance date (June 30, 2021) may be backdated to July 22, 2020.
Further billing instructions will be updated in the Substance Use Disorder Services section of the MHCP Provider Manual.
See the 1115 Substance Use Disorder (SUD) System Reform Demonstration webpage for more information or email email@example.com if you have questions about the demonstration project. (pub. 12/18/20)
Minnesota Department of Human Services (DHS) became aware of HAC claims denying with claim status code 116 during November. HAC services are “carved out” of managed care organization coverage and are covered through Minnesota Health Care Programs (MHCP) fee-for-service. HAC services are to be billed directly to MHCP with an approved service agreement.
We updated our system on Dec. 7, 2020, to resolve the claim denials. We will reprocess denied HAC claims with status code 116 submitted through Dec. 6, 2020. You do not need to resubmit claims. HAC providers should see the reprocessed claims on their future remittance advices. (pub. 12/15/20)
DHS, through its Behavioral Health Division, is seeking proposals from qualified responders to target opioid and stimulant use and misuse treatment, prevention and recovery services to address Minnesota’s opioid crisis. Information is due Jan. 8, 2021.
See “DHS is seeking to provide Targeted Opioid and Stimulant Use and Misuse Treatment, Prevention and Recovery Services” on the Open grants, RFPs and RFIs webpage for more information. (pub. 12/15/20)
Effective Nov. 11, 2020, the Department of Human Services’ (DHS) commissioner allowed Medical Assistance and MinnesotaCare members to receive coverage for investigational drugs, vaccines, devices and associated services that receive federal approval under an Emergency Use Authorization to treat or prevent COVID-19. Current state law prohibits Medical Assistance and MinnesotaCare coverage for investigational drugs, vaccines, devices and associated services.
The federal government approved the use of bamlanivimab in outpatient settings for patients experiencing mild to moderate COVID-19 symptoms. The federal government will purchase and distribute bamlanivimab. Providers are not allowed to seek reimbursement for any investigational drug, vaccine, or device that is provided at no cost through a federal distribution program. This change allows the state to reimburse health care providers for the associated services of administering the drug, including the office visit and monitoring time. This change also ensures coverage for any COVID-19 vaccines, which will likely receive approval under a federal Emergency Use Authorization.
This temporary change ensures Minnesota receives the enhanced federal funding available under the Families First Coronavirus Response Act by meeting the requirement for Medicaid agencies to cover all COVID-19 treatments. The change will continue through the end of the quarter in which the federal public health emergency ends. (pub. 12/7/20)
Certified day treatment providers of Children’s Therapeutic Services and Supports (CTSS) need to be aware of two billing changes effective Aug. 21, 2020, through the duration of the COVID-19 peacetime emergency.
Call the Minnesota Health Care Programs Provider Call Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 11/3/20)
The American Medical Association (AMA) allows coverage of additional expenses you incur related to preventing the spread of COVID-19 while safely providing patients quality care during in-person visits. Use procedure code 99072 to submit claims for the following:
Do not use code 99072 for items such as cell phones, cell phone minutes, telemedicine equipment or software, tablets, computers and so on.
Minnesota Health Care Programs will cover code 99072 retroactive to dates of service on or after Sept. 8, 2020. The covered code can be found on the MHCP fee schedule webpage. Code 99072 will be in effect until the peacetime emergency is terminated or rescinded by proper authority. See the AMA announces new CPT codes as COVID-19 advancements expand AMA webpage for more information about the code. See the COVID-19 CPT coding and guidance webpage for coding guidelines for code 99072. (pub. 10/27/20, rev. 12/8/20)
Residential service providers in Minnesota can now request short-term emergency temporary staffing if they’re experiencing a staffing shortage due to an outbreak of COVID-19 at their facility. Eligible provider organizations may receive temporary replacement staff for up to 14 days from a third-party staffing agency selected by the State of Minnesota.
All providers who offer residential services in group settings in Minnesota may be eligible to request staff from the staffing pool. This program is not limited to providers with a certain license or paid through Medical Assistance. Eligible providers and facilities include, but are not limited to:
See Aging and Adult Services and Disability Services Division’s Temporary staffing help available for residential service providers during COVID-19 eList announcement for eligibility and application information. (pub. 10/20/20)
Answers to frequently asked questions about the temporarily expanded use of telemedicine during the COVID-19 pandemic have been published on the COVID-19 Telemedicine FAQs: Behavioral Health Division webpage in response to provider inquiries. (pub. 6/10/20)
We have posted a new Coronavirus (COVID-19) manual section of the MHCP Provider Manual. It will include a list of temporary modifications to policies and procedures that have been made to Medical Assistance and MinnesotaCare programs. Unless listed in this manual section, all other program requirements continue to apply. Please refer to this manual section for the most up-to-date information. (pub. 4/2/20)
Executive orders signed by Gov. Tim Walz grant the Minnesota Department of Human Services (DHS) temporary authority to waive or modify administrative and regulatory requirements so that DHS and its partners can continue to provide essential programs and services to Minnesotans safely and without excessive delay during the COVID-19 pandemic.
See the Waivers and modifications webpage for information about waivers and modifications in effect, including those pending federal approval and changes made by the DHS commissioner under existing authority. (pub. 3/27/2020)
MHCP offers training for providers who provide services for members enrolled in MHCP. On-demand and online training opportunities have been updated and can be found on the MHCP provider training webpage.
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 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. Due to COVID-19, all instructor-led training is online only. We will update you on this webpage when, and if, we will continue in-person training. We have recently updated the look of the provider-specific training webpages and added the 2021 training dates. (pub. 12/22/20)
Minnesota Health Care Programs (MHCP) offers free online training for MHCP-enrolled providers. Go to the MHCP provider training webpage to see the list of available training.
We have added new training sessions for the following service providers:
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.
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. 2/5/20)