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.
The 2025 Minnesota Legislature extended the use of audio-only telehealth services by providers to July 1, 2027. Audio only is the delivery of health care services or consultations through telephone communication while the patient is at one site and the qualified health care provider is at a distant site. Refer to the Telehealth Services section of the Minnesota Health Care Programs Provider Manual for more information. (pub. 7/16/25)
Effective Aug. 5, 2025, EIDBI agency owners, operators, and direct service staff must complete a Minnesota Department of Human Services background study through NETStudy 2.0; and receive an eligible or set-aside result before providing EIDBI services. The requirement results from changes passed by the 2025 Minnesota Legislature.
We will share more information and resources in future eList announcements, Minnesota Health Care Programs Provider Manual updates, and on this webpage. (pub. 7/15/25)
The following are changes coming to the health care plans available in counties for the Prepaid Medical Assistance Program (PMAP) and MinnesotaCare.
For PMAP and MinnesotaCare members
Effective Sept. 1, 2025, UCare will no longer be available in the following counties for Prepaid Medical Assistance Program (PMAP) and MinnesotaCare:
Benton
Chisago
Crow Wing
Pennington
Ramsey
Roseau
Sherburne
Stearns
St. Louis
Wadena
Wright
For MinnesotaCare Members Only
As of July 1, 2025, Medica became available in Benton, Ramsey and Stearns counties for MinnesotaCare.
Effective Aug. 1, 2025, Medica will expand for MinnesotaCare only into the following counties:
Anoka
Carver
Dakota
Olmsted
Rice
Scott
Washington
For PMAP Members Only
Effective Sept. 1, 2025, Medica will be expanding for PMAP only into Benton and Kanabec counties.
Members Notified
The Minnesota Department of Human Services sent letters out to members notifying them of this change July 1-3, 2025. Members will need to choose a different plan available in their county. Refer members to our Maps online.
Providers must work directly with the members new managed care organization (MCO) for contracting information. Refer to MCO Contacts for MHCP providers.
If you have any questions, call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411.
If members have questions, refer them to their county or the Health Care Consumer Support line at 651-431-3722 or 833-970-0047. (pub. 7/15/25)
Effective immediately, MHCP now requires doula providers to submit their MDH certification letter that shows active registration dates with their enrollment or revalidation application. We now require this because MDH no longer lists start and end dates along with the individual name in their online doula registry so we are unable to verify dates through the registry.
Doula providers should note the following:
MHCP will return all enrollment requests (new or previously submitted) if they do not include the MDH certification letter; and we will ask that you resubmit the request with the certification letter. Allow 30 days from the date of the submission for processing.
You can submit the certification letter by uploading to the credentials page in the Minnesota Provider Screening and Enrollment portal.
Currently enrolled doula providers do not need to submit the MDH certification letter.
Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 7/7/25)
Effective July 2, 2025, MHCP will reimburse providers for Casgevy, a cell-based gene therapy for treating sickle cell disease, outside the APR-DRG, if the following criteria apply:
Casgevy is provided at an authorized treatment center.
Casgevy is submitted on a professional claim.
The individual receiving Casgevy is an MHCP member enrolled in fee-for-service.
The MHCP member has a diagnosis of sickle cell disease.
The provider has an approved prior authorization (PA) for Casgevy.
Casgevy is covered for transfusion-dependent beta-thalassemia, however, not outside the APR-DRG (PA is not required).
New Moving Home Minnesota (MHM) supplemental services are available to support a person’s transition from an institution to the community for certain programs starting July 1, 2025. The new supplemental services are a one-time service not covered by Medicaid.
The Minnesota Department of Human Services (DHS) has added detailed pages to the MHM Program Manual for each new supplemental service. These include:
Note: As of July 1, 2025, the “MHM Demonstration and Supplemental Services Table” is no longer in use. Review the MHM Program Manual for current policy details for each MHM service.
Services will go into effect for programs on separate dates Effective July 1, 2025, the new services are available to individuals enrolled in MHM who are also covered under:
Fee-for-service Medicaid
Special Needs BasicCare
Families and Children programs (such as, Prepaid Medical Assistance Program)
Starting Aug. 1, 2025, services will also be available to those enrolled in:
Minnesota Senior Health Options
Minnesota Senior Care Plus
This staggered rollout allows managed care organizations time to align with requirements in their senior managed care contracts.
Providers must enroll
Before providing these services, providers must be enrolled with Minnesota Health Care Programs. For detailed enrollment information, refer to the MHM Enrollment Criteria and Forms manual page.
MHM Supplemental Services Technical Assistance Sessions
MHM will hold technical assistance sessions on Monday, July 21, July 28, and Aug. 4 from 1 to 2 p.m. Calendar invites will be sent out for these sessions.
Training Opportunities
Training sessions for these new services are coming soon. Dates and times will be posted in an upcoming provider news update.
More information
DHS is working to add information about the new supplemental services and update forms. We will post a provider news when the updates are complete. (pub. 7/1/25)
The 2025 Minnesota Legislature passed changes that affect the EIDBI benefit. Refer to the EIDBI legislative updates DSD eList announcement to review a summary of the changes. We will share more information and resources about these changes in future eList announcements, Minnesota Health Care Programs Provider manual sections and this webpage. (pub. 7/1/25)
The Minnesota Department of Human Services (DHS) is holding questions and answers office hour sessions for Community First Services and Supports (CFSS) once a month.
The CFSS office hour sessions will have CFSS policy and enrollment staff in attendance. The focus of the sessions will be questions about CFSS policies, enrollment and the transition from personal care assistance to CFSS.
The Minnesota Legislature made changes to state laws affecting Housing Stabilization Services (HSS), including new requirements for provider enrollment.
Effective July 1, 2025, the Minnesota Department of Human Services (DHS) must complete a Pre-Enrollment Risk Assessment of any agency seeking to enroll as a Housing Stabilization Services provider.
The assessment of the agency will include:
History of performing services similar to those required for HSS.
Whether the services require the potential agency to perform duties at a significantly increased scale and, if so, whether the potential agency has the capability and organizational capacity to do so.
Financial information and internal controls.
Compliance with other state and federal requirements, including but not limited to debarment and suspension status, and standing with the Secretary of State, if applicable.
At any time when completing the Pre-Enrollment Risk Assessment, DHS may deem the potential agency ineligible and deny or rescind enrollment. A potential agency may appeal a decision regarding its eligibility in writing within 30 business days. The commissioner must notify each potential agency of the commissioner's final decision regarding its eligibility.
Additional information about the process will be published in July.
Current HSS providers
We will notify current providers when they must complete the Pre-Enrollment Risk Assessment. An explanation of this notification process will be included in the additional information we will be providing in July.
Any Housing Stabilization Services provider enrolled before July 1, 2025, that billed for services on or after Jan. 1, 2024, must complete the Pre-Enrollment Risk Assessment no later than July 1, 2026, to remain eligible. Any provider enrolled before July 1, 2025, that has not billed for services on or after Jan. 1, 2024, must complete the Pre-Enrollment Risk Assessment to remain eligible.
Other HSS-related legislation
The 2025 legislative session resulted in additional changes to Minnesota Statutes, 256B.051 as well as other sections of statute that apply to Housing Stabilization Services. We are preparing a summary of the new legislation that will be shared through GovDelivery and this webpage in July 2025. (pub. 6/27/25)
Beginning July 1, 2025, providers who want to enroll as an HSS provider or an RE provider need an approved PERA before submitting their enrollment applications. Enrollment applications received on or after July 1, 2025, will not be processed until Provider Eligibility and Compliance receives a copy of the PERA approval letter issued to the provider.
Any HSS or RE provider enrolled before July 1, 2025, that billed for services on or after Jan. 1, 2024, must complete the Pre-Enrollment risk assessment on a schedule determined by the commissioner and no later than July 1, 2026, to remain eligible. Minnesota Department of Human Services will notify providers of this process when it is available.
We are finalizing the PERA process and will have more information for providers. Please continue to watch this webpage for more information.
Information for House Stabilization Services providers
The Centers for Medicare & Medicaid Services (CMS) has issued an alert about a Medicare fraud scheme that targets providers and suppliers via fax. Refer to the Alert: Medicare Fraud Scheme Involving Phishing Fax Requests message on the CMS’ Crushing Fraud, Waste, & Abuse webpage for more information about the scheme and how to protect yourself. (pub. 6/27/25)
We revised this message to reflect that Minnesota Health Care Programs (MHCP) members with county-based purchasing coverage are not impacted by the potential implementation of a single DBA for MHCP effective Jan. 1, 2028.
The Minnesota Legislature has extended the deadline for the potential implementation of a single DBA for Minnesota Health Care Programs (MHCP) to Jan. 1, 2028.
In 2021, the Minnesota Legislature established a utilization benchmark of 55 percent for managed care organizations (MCOs) and county-based purchasing plans that contract with the Minnesota Department of Human Services (DHS) to administer the dental benefit in Medical Assistance (MA) (Minnesota Statutes, 256B.0371). This benchmark was set for calendar year 2024. The original legislation stated that if this benchmark was not met, DHS would be required to contract with a single DBA for MHCP by Jan. 1, 2026; however, the deadline for implementation is now Jan. 1, 2028.
DHS began planning for the potential 2026 deadline, including issuing a request for proposal and selecting Delta Dental of Minnesota as the DBA. We will continue to work with Delta Dental of Minnesota in accordance with the new deadline.
Note, if the 55 percent utilization benchmark is met, the single DBA will not be implemented. If the benchmark is not met, the single DBA will go into effect on Jan. 1, 2028. This would apply to all MHCP members, including those with coverage from MA, MHCP fee-for-service, managed care, Program HH or MinnesotaCare.
Providers do not need to take any action at this time.
We will provide updates and instructions throughout the coming months. (pub. 6/17/25, rev. 6/24/25)
The Minnesota Department of Human Services sent the following providers a memo in their MN–ITS PRVLTR folder on June 16, 2025:
Personal Care Assistance (PCA) Choice and
Community First Services and Supports (CFSS) budget model agencies
Financial Management Service (FMS) providers
The subject of the memo was “Service Employees International Union (SEIU) Healthcare Minnesota and Iowa Contract Requirements for 2025-2027.”
PCA Choice, CFSS budget model agencies and FMS providers are responsible for knowing the information contained in the memo and for implementing the contract terms on their effective dates. (pub. 6/18/25)
The Minnesota Legislature has acted to end MinnesotaCare eligibility for adults who are undocumented in the state. The mandated changes are effective June 15, 2025. Minnesota Department of Human Services continues work to implement these changes and the following is what we know right now about MinnesotaCare coverage for undocumented adults and children effective June 15. We will share more information as it becomes available.
Kids under the age of 18 who are undocumented and from low-income families will keep their coverage and can continue to apply and gain new eligibility.
After coverage begins for eligible undocumented kids, it can last up until the month after a child’s 18th birthday.
Adults who are undocumented and currently covered remain eligible for the program through the end of 2025.
Those who had coverage on June 15, 2025, will keep it through the end of the year as long as they continue to pay their premium, if they have one, and meet the income and other eligibility factors. Coverage for these adults will end at the close of the day Dec. 31, 2025.
Any new applications for coverage will be denied for Minnesotans age 18 or older who are undocumented.
We will update the MinnesotaCare eligibility system in the next couple of weeks and applications submitted by undocumented adults might be approved in the online system. However, those adults will receive a denial letter in the mail soon after applying in compliance with the change made by the Legislature. This may create confusion for people, and DHS is educating partners about the issue to minimize problems.
MinnesotaCare eligibility remains available for low-income Minnesotans who are:
U.S. citizens or U.S. nationals
Deferred Action for Childhood Arrivals grantees, also known as DACA or Dreamers.
Some options remain for Minnesotans who need care and have no insurance.
Emergency Medical Assistance remains available for people who are undocumented. This program pays for emergency care. Learn more on the Emergency Medical Assistance webpage.
Medical Assistance is available to any pregnant person regardless of immigration status and for 12-months postpartum or after giving birth. Learn more on the Health care coverage for pregnant people webpage. Medical Assistance is also available for people receiving services at the Center for Victims of Torture.
Minnesotans can receive health care from Minnesota Health Centers regardless of their ability to pay. Find a health center near you on the Minnesota Health Centers’ Find a Health Center webpage.
Minnesotans may be eligible for low-cost insulin through the Minnesota Insulin Safety Net Program. Learn more on the Minnesota Insulin Safety Net Program webpage.
Minnesota Health Care Programs (MHCP) revised authorization and billing requirements for mobility devices and accessories effective June 1, 2025.
MHCP is changing authorization from always to sometimes required for most manual wheelchairs, regardless of the device being requested for purchase or rental. The following devices only require authorization for excess quantities or as backup devices for power wheelchair users:
Standard wheelchairs (HCPCS code K0001)
Standard hemi wheelchairs (K0002)
Lightweight wheelchairs (K0003)
High-strength, lightweight wheelchairs (K0004)
Heavy-duty wheelchairs (K0006)
Extra-heavy-duty wheelchairs (K0007)
Rollabout chairs (E1031)
Transport chairs (E1037 to E1039)
MHCP requires authorization for all purchases and rentals of the following mobility devices:
Pediatric-size wheelchairs (E1229, E1231 to E1239)
Custom or other manual wheelchairs (K0008, K0009)Power-operated vehicles (K0800 to K0802, K0806 to K0808)
Power wheelchairs (K0813 to K0891)
Previously, the Mobility Devices section of the MHCP Provider Manual instructed providers to list all HCPCS codes on authorization requests for purchase, even if an individual HCPCS code does not require authorization. We have updated language for listing accessories. Providers should continue to document medical necessity for all items to be dispensed in the medical record, but only request authorization if the individual HCPCS code requires authorization.
We revised information under the Authorization heading of the Mobility Devices section of the MHCP Provider Manual to instruct providers to list all options and accessories, the specific medical justification for the mobility device, and each option or accessory in the medical record. Only include devices and accessories on authorization requests that always require authorization or for excess quantities. The following items always require authorization:
One-arm drive attachments (HCPCS code E0958)
Push-rim activated power assist systems (E0986)
Power tilt seating systems (E1002)
Power recline seating systems (E1003 to E1005)
Power tilt and recline seating systems (E1006 to E1008)
Mechanical leg elevation systems (E1009)
Power leg elevation systems (E1010, E1012)
Gimbaled ventilator trays (E1030)
Multi-positional transfer systems (E1035, E1036)
Gear reduction drive wheelchairs (E2227)
Wheel braking systems (E2228)
Manual standing systems (E2230)
Power seat elevation systems (E2298)
Power standing systems (E2301)
Electronic components for motors controlled by interfaces (E2310, E2311)
Alternative interface devices (E2313, E2321 to E2331, E2373, E2399)
Custom fabricated seating systems (E2609, E2617)
Powered seat cushions (E2610)
Mobile arm supports and additions (E2626 to E2623)
Previously, custom fabricated seating systems required authorization if the submitted charge was over $1,200. Authorization is now required always for HCPCS codes E2609 and E2617, regardless of the total amount. Powered seat cushions, which did not require authorization, also now always require authorization.
Authorization is required for HCPCS code K0108 when the submitted charge is $400 or more. Authorization is no longer required for any individual part that costs $400 or more. Authorization is only required if the individual HCPCS code always requires authorization or for excess quantities.
Under the Billing heading of the Mobility Devices section of the MHCP Provider Manual, we instruct providers to document which accessories and options are included with a mobility device. Do not bill MHCP for standard items included at the time of the initial issue of a wheelchair. Bill two claims, one for HCPCS codes that do not require authorization, and one for HCPCS codes that do require authorization.
Review the Mobility Devices section of the MHCP Provider Manual and the Medical Supply Coverage Guide (PDF) for information on MHCP authorization requirements and quantity limits by HCPCS code. Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 6/17/25)
Minnesota Health Care Programs will host an additional training session on Wednesday, July 16, 2025, because of the unexpected technical issues experienced during the June 11, 2025, session.
Minnesota Health Care Programs (MHCP) recently made system updates to enhance the processing of certain Certified Community Behavioral Health Clinic (CCBHC) claims.
Mental health claims submitted by CCBHC Federal Demonstration providers incorrectly processed with a 3% mental health rate add on.
We have completed a claim adjustment to correct the impacted claims with dates of services Jan. 1, 2024, through June 6, 2025. The reprocessing was finalized on June 6, 2025, and the corrected claims are expected to appear on your June 17, 2025, remittance advice.
You do not need to take any further action. (pub. 6/16/25)
We have revised this message to explain reprocessed claims may appear on the June 17 or July 1 remittance advice. Minnesota Health Care Programs has begun reprocessing certain mental health service claims to incorporate a 3.27% inflationary adjustment to 2025 reimbursement rates.
The adjustment is based on the MEI and reflects the change in MEI from the midpoint of the previous rate year (2024) to the midpoint of the current rate year (2025). We used the MEI forecast published in the fourth quarter of calendar year 2024 by the Centers for Medicare & Medicaid Services. Minnesota uses MEI to account for changes in the cost of providing services, such as wages, benefits, and overhead.
Impacted claims will be adjusted according to the Rate adjustments for certain mental health services message posted March 10, 2025, on the Provider news and updates (PDF).
We will reprocess claims submitted with dates of services Jan. 1, 2025, through June 3, 2025. You do not need to take further action while we reprocess claims. The reprocessed claims will appear on your June 17, 2025, or July 1, 2025, remittance advice. (pub. 6/12/25, rev. 6/16/25)
Providers who submitted Personal Care Assistance and Community First Services and Supports claims and received MN–ITS claim status code 132 and remittance advice (RA) remark code N290 on their June 3 or June 17 RA need to resubmit their denied or replace partially paid claims. We changed inactive DSW enrollment records to active on June 4, 2025.
If you have resubmitted claims on or after June 4, 2025, and are still experiencing denied claims with these claim status and remark codes, call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411. (pub. 6/6/25)
The Minnesota Department of Human Services’ (DHS) Community First Services and Supports (CFSS) Cost Reporting Team will host demonstration and question and answer (Q&A) webinars about cost reporting for personal care assistance (PCA) and CFSS agency providers. The team will explain what cost reporting is, demonstrate how to use the system and answer attendees’ questions.
Webinars will be held from 10 - 11:30 a.m. on the following dates:
The Minnesota Legislature directed DHS to develop a provider cost reporting process for agencies that provide agency model PCA or CFSS services (Minnesota Statutes, 256B.851, subdivision 8).
All agencies that provide agency model PCA or CFSS services must submit a completed cost report by the deadline established by DHS. DHS may stop paying you for services you provide if you fail to complete the cost report. Refer to the CFSS cost reporting webpage for more information and timelines about when your agency will be selected to complete cost reporting.
Due to new legislative updates and revalidations, the MHCP Provider Resource Center is experiencing high call volume. You may experience a longer wait time or you will have to call back at a different time.
The Minnesota Department of Human Services will be offering weekly questions and answers sessions for the MPSE Portal. Questions and answers sessions take place every Wednesday from 1 to 2 p.m. starting on Feb. 7, 2024. These sessions are free and no registration is required.
MPSE questions and answers sessions will be held virtually using the Microsoft Teams platform, but attendees do not need to have Microsoft Teams installed. Participants can use the browser version. Find the link to join the questions and answers session on the MPSE portal training webpage.
Who should attend?
Owners of MHCP-enrolled organizations.
Individual providers who maintain their own MHCP enrollment records.
Employees of MHCP-enrolled organizations who maintain provider enrollment records.
Employees of MHCP-enrolled organizations who process affiliations or do credentialing.
Employees of MHCP-enrolled organizations responsible for MHCP compliance.
Individuals or organizations interested in becoming an MHCP provider for the first time.
Anyone interested in learning more about the MPSE portal.
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. (rev. 3/3/25)
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. Refer to the 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 about 10 minutes and provides instructions on a concept or technique. (pub. 6/3/25)
