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.
Systems announcements
We will update this section with information about MN–ITS availability, technical information and other systems announcements when necessary.
MN–ITS and other systems are experiencing intermittent technical issues when users attempt to log in. We are aware of the issue and are working to resolve it as quickly as possible. If something does not appear to be working correctly, please try again later.
The U.S. Department of Health and Human Services (HHS) announced on June 9, 2020, additional distributions from the $50 billion Provider Relief Fund. The deadline to apply for federal funds has been extended to Aug. 28, 2020.
Approximately $15 billion will go to eligible Medicaid and Children's Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs and that have not already received funds from the Provider Relief Fund. These payments will not be made automatically. Providers need to go to the federal portal to apply for this support. Eligible providers must have directly billed either their state Medicaid/CHIP programs (DHS) or Medicaid-managed care plans for health care-related services during the period of Jan. 1, 2018, to May 31, 2020. Nearly 1 million providers may be eligible across the country.
HHS also announced the distribution of $10 billion in Provider Relief Funds to safety net hospitals, those hospitals that serve our most vulnerable citizens. Recognizing the incredibly thin margins these organizations operate on, these payments will be made directly to hospitals this week via direct deposit.
Providers are encouraged to apply even if they are uncertain if they are eligible. More information about the requirements and distributions is available online at the HHS website, including these recently updated resources:
On July 22, 2020, there was a system update, which caused service agreements to be sent to some HCBS waiver providers, and also caused some lead agencies to experience disruptions when making changes to service agreements.
The message that appeared on the service agreements read: “858 PROVIDERS MUST CONTINUE TO BE ELIGIBLE & ENROLLED TO PROVIDE THIS SERVICE IN ORDER FOR THIS AUTHORIZATION LINE ITEM TO BE VALID. THIS SERVICE LINE ITEM IS NOT CURRENTLY SUPPORTED.”
Minnesota Health Care Programs (MHCP) is currently working on fixing the disruption the update caused.
We will send out a provider news update once this issue has been resolved. (pub. 8/6/20)
Federal funds are available for eligible Medicaid and Children's Health Insurance Program (CHIP) providers, including mental health and SUD providers, who participate in state Medicaid and CHIP programs and have not already received funds from the Provider Relief Fund. The deadline to submit an application for provider relief funds is Aug. 28, 2020.
Read the Behavior Health Division’s Facilitating provider access to relief funds e-Memo to learn what information SAMHSA is requesting from all behavioral health providers to facilitate the process. (pub. 7/31/20)
The Minnesota Department of Human Services (DHS) implemented the July 1, 2019, hospital inpatient rates on June 6, 2020.
We are reprocessing all hospital inpatient claims submitted before June 6, 2020, with discharge dates on or after July 1, 2019. All reprocessed hospital inpatient claims will appear on your Aug. 4, 2020, remittance advice. See the Payment Methodology for Inpatient Hospital webpage for more information about inpatient rates. (pub. 7/31/20)
U.S. Department of Health and Human Services (HHS) Secretary Alex M. Azar again renewed the COVID-19 public health emergency effective July 25, 2020. See the HSS’ Renewal of Determination That A Public Health Emergency Exists webpage to read the official declaration of this renewal. (pub. 7/27/20)
The Minnesota Department of Human Services (DHS) requests public comments on Summer 2020 federal waiver plan amendments (PDF) before submitting to the Centers for Medicare & Medicaid Services (CMS) for approval. We are holding a 30-day public comment period beginning July 24, 2020, through Aug. 24, 2020. See the DSD eList announcement DHS requests public comments on amendments to the disability waiver plans to review these amendments, learn how to submit comments and how to request a copy of the amendment document. (pub. 7/27/20)
Housing Stabilization Services is a new Minnesota Medical Assistance benefit to help seniors and people with disabilities find and keep housing. Services began Monday, July 20, 2020. Providers may submit documentation for member eligibility of Housing Stabilization Services through our secure web-based platform to determine medical need for services. Providers who want to learn more about the service or enrolling to deliver this service can find information in the Housing Stabilization Services section of the Minnesota Health Care Programs Provider Manual and on the Housing and homelessness: Policies and procedures webpage.
Billing information
We are updating our system to allow billing for these services and we expect the update to be completed by Aug. 31, 2020. We will provide an update and confirm the billing start date later. Providers who are providing Housing Stabilization Services will be able to bill for services on the date the member was found eligible to receive Housing Stabilization Services. (pub. 7/22/20)
MHCP corrected the system and Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) Child and Teen Checkup (C&TC) claims are reimbursing at the encounter rate. MHCP will reprocess all affected FQHC and RHC C&TC claims. The reprocessed claims will appear on your remittance advice dated no later than Aug. 4, 2020. (pub. 7/21/20)
Housing Stabilization Services providers who provide housing sustaining services in provider owned or controlled settings must enroll each setting separately with Minnesota Health Care Programs (MHCP). An enrollment fee payment for each enrolled site is required. See Minnesota Statutes 256B.04, subd. 21, for more information on the enrollment requirements.
Provider Eligibility and Compliance will contact housing sustaining providers who are already enrolled with MHCP with a request for more information if additional settings need to be enrolled.
This will not affect housing consultation providers or housing transition providers. (pub. 7/21/20)
The Centers for Medicare & Medicaid Services National Correct Coding Initiative established an edit for mental health Partial Hospitalization Program (PHP) HCPCS code H0035 with a maximum unit of one per day beginning Jan. 1, 2019. This change went into effect before our system work was completed.
In July 2019, Minnesota Health Care Programs provided instructions for resubmitting claims for HCPCS code H0035 using the 2018 hourly rate to reimburse claims for dates of services beginning Jan. 1, 2019, through July 15, 2019. DHS has extended the date to resubmit these claims to Oct. 8, 2020, due to a delay in updating our reimbursement system.
Use the following steps to resubmit denied or incorrectly paid claims for dates of services Jan. 1, 2019, through July 15, 2019. A claims specialist will be able to override the timely filing deadline restrictions for payment if there are no other denial issues.
Change the service unit to 1 unit.
In the “Reference” (Loop: 2300, NTE01) field, enter Updated Information “UPI.”
In the “Text” (Loop: 2300, NTE02) field, enter the number of hours provided.
These instructions do not apply to claims submitted for dates of service after July 15, 2019.
This extension only applies to PHP providers billing for the HCPCS procedure code H0035 that the Centers for Medicare & Medicaid Services changed from an hourly code to a session code in 2019. This extension expires on Oct. 8, 2020.
If you need help with attaching this message to your claim, call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411. (pub. 7/13/20)
The Department of Human Services (DHS) increased the billable monthly work hours for individual personal care assistants (PCAs) from 275 to 310 due to the peacetime emergency declaration. See the COVID-19 section of the Minnesota Health Care Programs Provider Manual for more information. Programming to allow the additional hours is now complete and effective as of May 1, 2020. DHS has reprocessed claims that were already submitted and denied due to the 275-hour limit and payment for these claims will be on the July 7, 2020, remittance advice. (pub. 7/8/20)
The rates increase for Doula Services passed by the 2019 legislature has been implemented. The updated rates are retroactive to July 1, 2019. All claims for dates of services from July 1, 2019, through June 24, 2020, will be reprocessed and will appear on the July 7, 2020, remittance advice. Providers do not need to resubmit claims and can continue to bill claims as usual. (pub. 7/6/20)
The Minnesota Department of Human Services has posted a Health care coverage webpage to assist uninsured and low to no income Minnesotans find health care coverage. We are making you aware of this webpage and asking for your help in directing people who are looking for health care, especially during the COVID-19 pandemic, to this webpage. (pub. 7/2/20)
The Minnesota Department of Human Services’ (DHS) BHD has approved temporary waivers for recertification due to the COVID-19 peacetime emergency for the providers of the following services:
Dialectical Behavior Therapy (DBT)
Assertive Community Treatment (ACT)
Intensive Treatment Foster Care (ITFC)
Adult Rehabilitative Mental Health Services (ARMHS)
Statute or DHS policy requires initial certification and recertification on varying intervals for each of these service types. Without current certification, provider entities will not be able to continue service provision without current certification and members are at risk of losing critical access and supports.
ACT and ARMHS providers
If your certification expired on or after Mar. 20, 2020, you have until the end of the peacetime emergency to recertify.
ITFC and DBT providers
If your certification expired on or after Mar. 20, 2020, you have until July 31, 2020, or until the end of the peacetime emergency, whichever is later, to recertify.
Call the Minnesota Health Care Programs Provider Call Center at 651-431-2700 or 800-366-5411 if you have questions about recertification.
DHS staff will continue to provide technical assistance and support using virtual means to all the providers. (pub. 7/1/20)
Home and Community-Based Services designation (Integrated licensing)
Home management registrations
Housing with services establishments
Current licenses are considered active and in good standing with MDH due to MDH’s temporary suspension of accepting renewal applications. Minnesota Health Care Programs (MHCP) will continue to process claims billed as usual.
Call MDH at 651-201-4101 if you have questions about MDH license and registration renewal suspension. Call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411, option 4, if you have questions about billing and claims. (pub. 6/30/20)
Federal Coronavirus Aid, Relief, and Economic Security (CARES) Act payments, also referred to as economic impact payments, recovery rebates or “stimulus checks,” are intended for the recipients, even if a nursing home or other facility or provider receives the person’s payment, either directly or indirectly by direct deposit or check. A person who receives Medical Assistance for Long Term Care (MA-LTC) is not required to contribute any amount of these payments to their nursing home, long-term care facility or long-term care provider. A person’s MA-LTC spenddown will not increase due to receipt of these payments. Nursing homes must refund any CARES Act payments that residents have already turned over to them.
Seizing residents’ CARES Act payments could be a violation of federal regulations at 42 CFR §483.12, freedom from abuse, neglect and exploitation, and of 42 CFR §483.10, giving residents the right to manage their own financial affairs. Facilities and other providers that seize these payments from residents could be subject to federal enforcement actions, including potential termination from participation in the Medicare and Medicaid programs.
The Centers for Medicare & Medicaid Services (CMS) and state investigators will refer any nursing home they find in violation of these requirements to the state attorney general, as appropriate.
Representative Payees
The Social Security Administration (SSA) has issued FAQs on this issue, including how representative payees should handle administering the payments for the recipient. SSA has noted that under the Social Security Act, a representative payee is only responsible for managing Social Security or Supplemental Security Income (SSI) benefits. CARES Act payments are not such a benefit. (pub. 6/29/20)
Beginning Jan. 1, 2020, until the end of the quarter the COVID-19 federal emergency has ended, the Families First Coronavirus Response Act (Public Law No. 116-127, section 6008) provides a temporary increase of 6.2 percent 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 received a 6.2 percent state funds rate increase and were replaced on the June 9, 2020, MMIS warrant
County-provided Targeted Case Management services (Child Welfare, Mental Health and Vulnerable Adult-Developmental Disability)
The 6.2 percent increase does not apply to adults without children and other populations already receiving an enhanced FMAP.
Minnesota Health Care Programs (MHCP) will automatically reprocess paid claims from warrant dates Jan. 7, 2020, through May 12, 2020. You will see this on the June 23, 2020, remittance advice. Counties and providers do not need to do anything to receive the increased FMAP. Claims paid from May 27, 2020, until the end of the quarter the COVID-19 federal emergency has ended (defined by federal government) will be paid at the higher 56.2 percent rate.
Contact the MHCP Provider Call Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 6/19/20)
Minnesota Health Care Programs (MHCP) is aware of CPT codes 99441, 99442 and 99443 denying claims for members in FP and MFPP. We have fixed the system to correctly pay. We will reprocess all affected claims with dates of services back to Mar. 19, 2020. The reprocessed claims will appear on the June 23, 2020, remittance advice. Providers do not need to resubmit claims and can continue to bill claims as usual. See the Covered Services Changes and Modifications section of the Coronavirus (COVID-19) section of the MHCP Provider Manual for more information about the codes. (pub. 6/18/20)
Minnesota Department of Human Services and the Minnesota Department of Health are committed to protecting people who work and receive support in their homes and communities. Together, we recently published guidance that provides important information and recommendations to minimize exposure and transmission of COVID-19 for PCA agencies and other home and community-based service providers of in-home services. It includes information about:
Standard precautions
Symptoms and early detection
Transmission-based precautions
Emergency back-up plans and preventing service interruptions
The Minnesota Department of Human Services (DHS) will provide a 50 percent rate add-on for customized living services for 45 days, beginning with the date the provider had at least one COVID-19 exposure at the setting, as determined by the Minnesota Department of Health. This rate add-on is available to providers who have had at least one COVID-19 exposure between Mar. 13, 2020, and July 31, 2020.
The rate add-on payments are not intended to meet increased needs of individual waiver participants, but to help providers of customized living services meet the health and safety needs of waiver program members in settings that have one or more confirmed COVID-19 exposures. The add-on payments will help cover the following kinds of costs:
Additional personal protective equipment
Additional staff time to adjust service delivery to implement recommended or mandated public health practices, such as social distancing, screening staff or visitors for health concerns
Implementation of infection control procedures, such as additional facility cleaning and disinfecting
Paid sick leave for staff, replacement staff or overtime pay
DHS will send attestation forms directly to Minnesota Health Care Programs enrolled customized living providers in identified settings as soon as DHS determines a provider is eligible for add-on payments.
The Minnesota Department of Human Services (DHS) has opened the COVID-19 Provider Alert Survey to identify challenges faced by adult foster care and supported living services providers during the COVID-19 pandemic. These COVID-related pressures include:
The number of confirmed or suspected COVID-19 infections
The need for personal protective equipment and monitoring equipment
Staffing and service capacity
This survey is voluntary. We will use the information submitted about the types and scope of COVID-19 impacts among providers to improve systems and inform emergency response coordination among state and local agencies. See the Provider alert survey for critical COVID-19 pressures webpage for more information and to complete the survey. (pub. 6/12/20)
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)
Minnesota Department of Human Services has made temporary policy modifications to PCA services in response to the COVID-19 pandemic.
Allow qualified professionals to provide remote services for all people who receive PCA services. Qualified professionals may provide all required in-person oversight via two-way interactive telecommunications (phone or internet technology, for example) for all people who receive services, including people who are new to receiving PCA services or transferring to the agency. Remote service delivery for supervisory visits was approved retroactively to Mar. 19, 2020, for both Choice and traditional models of PCA services.
Increase the number of hours a PCA provider agency can bill for an individual worker. PCA provider agencies may bill up to a maximum of 310 hours per month, per individual worker, for the services an individual worker provides to a person who receives PCA services beginning May 1, 2020, through the duration of the COVID-19 peacetime emergency. We are updating the MMIS claims system to allow for the increase and we will update you when that is complete. You may submit claims for the increased hours now. The claims will deny and we will reprocess them after the system has been updated.
DHS will publish a bulletin outlining these changes under Waivers under peacetime emergency authority, Executive Order 20-12, No. 32 on the Waivers and modifications webpage.
These changes affect PCA services authorized through:
Medical Assistance state plan
Alternative Care program
Extended PCA authorized under the Home and Community-Based Services (HCBS) waivers
See the Coronavirus (COVID-19) section of the Minnesota Health Care Programs Provider Manual for more information about these changes, including documentation and billing instructions. (pub. 6/3/20, rev. 7/21/20, rev. 7/22/20)
Minnesota Health Care Programs (MHCP) has temporarily increased the reimbursement rates for the three telephone evaluation and management procedure codes, 99441, 99442 and 99443, retroactive to dates of service on or after Mar. 19, 2020. MHCP reprocessed paid claims back to that date on May 22, 2020, and the temporary rates will be in effect until the peacetime emergency is terminated or rescinded by proper authority. These codes are listed in the Coronavirus (COVID-19) section of the MHCP Provider Manual under covered services changes and modifications via telemedicine. Reprocessed claims will appear on your May 27, 2020, remittance advice. Updated rates can be found in the MHCP fee schedule. No further action is required by providers. (pub. 5/27/20)
The Minnesota Department of Human Services commissioner will allow remote support (real-time, two-way communication) as a service delivery option for several waiver services temporarily during the COVID-19 pandemic beginning Apr. 29, 2020. Remote support may be delivered through phone or other interactive technology mediums currently available to the person receiving services. See more information added to the Coronavirus (COVID-19) section of the MHCP Provider Manual. You may also refer to Bulletin 20-48-01 Temporary expansion of remote support for home and community-based services (HCBS) waivers (PDF) for more information on the remote support policy, including a list of services that may be provided remotely, types of technology applications that can be used, lead agency instructions for rates and authorization, and provider instructions to add services on 245D license and enrollment record. (pub. 5/20/20)
The Minnesota Department of Human Services commissioner authorizes licensed adult day service providers to provide services remotely or in person to one person at a time beginning Apr. 29, 2020.
Alternative adult day services include the following services:
Wellness checks and health-related services, including medication set-up and administration overseen by a nurse
Socialization or companionship
Activities
Meals delivered to the person’s home
Assistance with activities of daily living, including bathing
The Minnesota Department of Human Services (DHS) under Governor's Emergency Executive Order 20-12 has temporarily waived the policy requirement for a signed service plan when it is not possible to obtain a signature from the client or the client’s parent or legal representative. Verbal acknowledgement of the service plan via the telephone or through videoconference instead of a written signature is allowed temporarily until the emergency order has been lifted.
Effective Mar. 1, 2020, Child Welfare Targeted Case Management (CW-TCM) and Mental Health Targeted Case Management (MH-TCM) case managers may complete a service plan with the child and parent, legal guardian or legal representative; or the adult and legal representative via the telephone or through videoconference.
CW-TCM and MH-TCM service plan effective dates
The CW-TCM service plan effective date is the date the parent or legal guardian or legal representative acknowledges the CW-TCM service plan.
The MH-TCM service plan effective date is the date the MH-TCM clinical supervisor acknowledges the MH-TCM service plan. This clarification applies to fee for service and managed care.
Case manager responsibilities
The case manager must:
Document who gave verbal acknowledgement and their relationship to the client in the client file
Document when the verbal acknowledgement was received
Send a copy of the completed CW-TCM service plan to the child and parent, legal guardian or legal representative
Send a copy of the completed MH-TCM service plan to the child and parent, legal guardian or legal representative; or the adult or legal representative
The commissioner of the Minnesota Department of Human Services (DHS) approved a waiver to state statute to allow psychiatric care providers on ACT and IRMHS teams to temporarily provide via telemedicine.
Previous telemedicine waivers allowed the temporary use of telemedicine by mental health professionals and practitioners who were not directly prohibited from telemedicine by state statute. This waiver specifically allows the temporary use of telemedicine by psychiatric care providers on ACT and IRMHS teams who were directly prohibited from telemedicine by state statute. This ensures that the more than 2,400 members served by these teams will keep their access to important psychiatric mental health services such as assessment, medication management and symptom and risk monitoring during the COVID-19 pandemic.
Follow the video and telephone telemedicine billing guidance in the Coronavirus (COVID-19) section of the Minnesota Health Care Programs (MHCP) Provider Manual. Providing telemedicine remains in effect until the peacetime emergency is terminated or until it is rescinded by proper authority. Contact the MHCP Provider Call Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 5/11/20)
The Minnesota Department of Human Services has modified EIDBI policy due to the COVID-19 pandemic. EIDBI providers can adjust how they provide services during the length of the peacetime emergency. See the EIDBI policy changes in response to the COVID-19 emergency Disability Services Division (DSD) eList announcements on the Latest information about COVID-19 from DSD webpage for information. For information about providing services via telemedicine, see the Coronavirus (COVID-19) section of the Minnesota Health Care Programs Provider Manual. (pub. 5/6/20)
The Minnesota Health Care Programs’ (MHCP) temporary expansion of coverage for telemedicine visits includes CCBHC services. The expansion of telemedicine coverage applies to CCBHCs that meet the requirements under Minnesota Statute 256B.0625 subdivision 3b, and the additional provider types and services listed on the recently approved Waivers and modifications webpage. Services provided via telemedicine according to all applicable requirements in the Coronavirus (COVID-19) section of the MHCP Provider Manual will satisfy the face-to-face requirement for services in the CCBHC scope of services table for the purpose of calculating the monthly wrap payment.
See the Coronavirus (COVID-19 section of the MHCP Provider Manual for more information on the temporary changes to telemedicine visits. See the Waivers and modifications webpage for more information about the telemedicine waivers.
We updated the Scope of Services for CCBHCs (PDF) table to include evaluation and management (E&M) telephonic billing codes made effective due to the COVID-19 emergency orders. E&M services listed on the CCBHC scope of services table provided according to all applicable requirements in the Physician Consultation, Evaluation and Management section of the MHCP Provider Manual and according to all applicable requirements in the Coronavirus (COVID-19) section of the MHCP Provider Manual are considered CCBHC encounters. (pub. 5/6/20)
On Mar. 18, 2020, Congress passed the Families First Coronavirus Response Act (FFCRA), which gives states the option to make Medicaid available to certain uninsured people to pay for COVID-19 testing and the related office visit during the COVID-19 peacetime emergency.
The Minnesota Legislature authorized a new Medical Assistance (MA) coverage group for those who are uninsured to cover the testing and diagnosis of COVID-19. This change eliminates the financial barriers that might prevent someone who needs testing for COVID-19 from seeking care, increasing public health care risks.
The new coverage group is effective May 1, 2020, and ends when the COVID-19 peacetime emergency ends.
For this new MA coverage for COVID-19 testing group, only the testing and services related to diagnosis of COVID-19 are covered. This includes coverage for the COVID-19 test, serological tests and the office visit during which the test was given. Services for the treatment of COVID-19 are not included. There are no copays or deductibles for COVID-19 testing and the evaluation. A person can have more than one COVID-19 test covered while they are enrolled in this program.
Ensure the patient has completed all information necessary.
Complete the provider portion of the application and submit the application to the Department of Human Services (DHS). DHS staff will determine eligibility.
Verify eligibility and submit the claim(s) to DHS for processing.
Information on eligibility status will be available in the Eligibility Verification System (EVS) within 10 days of submission of the application.
Bill DHS for the COVID-19 testing and evaluation through MN–ITS.
Uninsured individuals are always encouraged to complete the appropriate Minnesota Health Care Programs application. Completing an application for MA or MinnesotaCare is not a requirement to qualify for MA coverage for COVID-19 testing.
Refer to the COVID-19 section of the MHCP Provider Manual for more information about temporary modifications due to COVID-19. (pub. 5/1/20)
The Minnesota Department of Human Services (DHS) reminds providers of the following information about C&TC visits during the COVID-19 pandemic.
For children age 24 months or younger
DHS and the Minnesota Department of Health (MDH) recommend to continue in-person C&TC visits for children 24 months or younger to receive necessary immunizations and other screenings. To reduce the risk of spreading disease, see the Apr. 1, 2020, Provider news and updates message "Child and Teen Checkups (C&TC) well child visit prioritization guidance during COVID-19 pandemic."
If a practice is unable to provide a C&TC visit to a child aged 24 months or younger (for example, a caregiver in the home is positive for COVID-19 or does not feel comfortable coming into the office), providers may complete components of the visit via telemedicine (for example, history, anticipatory guidance, vaccine counseling and developmental screening) based on their clinical judgment. Report only the codes of the services provided, and payment will reflect only those completed components per the Minnesota Health Care Programs (MHCP) Fee Schedule. See the Covered Services Changes and Eligible Providers sections of the Coronavirus (COVID-19) section of the MHCP Provider Manual and the "Telemedicine information and documentation" section of this message for information about enrollment and providing via telemedicine during the COVID-19 pandemic.
For children older than 24 months
Providers may perform condensed C&TC visits using telemedicine. Providers will need to use their clinical judgment as to which components of the C&TC service are appropriate to be performed during the telemedicine visit, and payment will reflect only those completed components per the MHCP Fee Schedule.
Telemedicine information and documentation
MHCP will include delivery of services through telephone connection between the patient and provider as part of telemedicine services effective Mar. 19, 2020. Providing telemedicine via phone for COVID-19 remains in effect until the peacetime emergency is terminated or until it is rescinded by proper authority. See the Covered Services Changes and Eligible Providers sections of the Coronavirus (COVID-19) section of the MHCP Provider Manual for information about enrolling and providing via telemedicine.
MHCP will cover medically necessary services and consultation by an MHCP provider through telephonic telemedicine in the same manner as if the service or consultation was delivered in person on an interim basis during the COVID-19 pandemic. Refer to the Telemedicine/Telephonic Telemedicine Providers provider list in MN–ITS to see if you’ve been approve to provide telemedicine or telephonic services. You must use the Chrome browser to view the list.
If you are providing condensed and modified C&TC services and not all the components of a visit, leave off the S0302 code and HIPAA-compliant referral condition codes. All provisions discussed here are time limited. Consult the Coronavirus (COVID-19) section of the MHCP Provider Manual regularly for the most up-to-date information.
Follow-up after the COVID-19 pandemic
Any member who receives a preventive medicine visit via telemedicine should have a complete in-person C&TC visit as soon as possible after the COVID-19 peacetime emergency has formally ended. Consideration of completion of further face-to-face visit components, follow-up care or the timeline of the next complete age-related face-to-face C&TC visit is at the provider’s discretion. See the Child and Teen Checkups (C&TC) section of the MHCP Provider Manual for more information.
Federally approved policy modifications to targeted case management (TCM) services temporarily allow telephone and video-conferencing in place of in-person face-to-face contact during the COVID-19 pandemic.
See the Coronavirus (COVID-19) section of the Minnesota Health Care Programs Provider Manual for information about providing targeted case management services during this pandemic.
The change is effective Mar. 19, 2020, and allows case managers to conduct targeted case management visits by phone or video with adults receiving services or their legal guardians, and with children receiving services and their parents or legal guardians. The change runs through the end of the public health emergency.
Tribal provider requirements
This change means that Indian Health Services (IHS), Sec. 638 Tribal providers, may receive the daily encounter payment when the contact between the case manager and the person receiving services happens by telephone instead of through an in-person face-to-face visit. Although the mode of how a service may be delivered is temporarily changing (for example, targeted case management services can be delivered via telephone temporarily), there are no changes to the payment methodology for the daily encounter payment. The same services and types of providers that are required to generate a daily encounter payment continue to be required when targeted case management services are delivered during the COVID-19 emergency period.
The affected services include:
Child welfare targeted case management
Children’s mental health targeted case management
Adult mental health targeted case management
Vulnerable adult or adult with developmental disabilities (VA/DD) targeted case management
Relocation service coordination targeted case management
Minnesota Department of Human Services (DHS) has expanded access to telemedicine to ensure the 1.1 million Minnesotans covered by Medical Assistance and MinnesotaCare do not lose access to care and services, including mental health and substance use disorder coverage, during the pandemic.
DHS has received federal approval to temporarily ease certain limits in existing law for receiving needed care and services through telephone and video visits that can instead be provided safely and effectively without an in-person face-to-face visit by:
Expanding the definition of telemedicine to include telephone calls so providers who have a telemedicine agreement in place with DHS can serve patients through telephone or tele-video visits.
Allowing a provider’s first visit with a patient to be conducted over the phone.
Allowing Medical Assistance and MinnesotaCare enrollees to have more than three telemedicine visits in a week.
Allowing DHS-contracted managed care plans to follow these same policies.
All telemedicine changes are effective Mar. 19, 2020.
DHS received Centers for Medicare & Medicaid Services approval for temporarily expanding the providers that may deliver services using telemedicine, including many mental health and substance use disorder (SUD) treatment providers. This approval also applies to equivalent tribal providers. See the Temporary coverage of telemedicine visits for Substance Use Disorder and Mental Health providers webpage for information about telemedicine for mental health and SUD.
DHS also received temporary approval to allow a telemedicine service to satisfy the face-to-face requirement under the encounter payment methods for Indian Health Service, Tribal 638 clinic, Federally Qualified Health Center, and Rural Health Clinic services. If a service would have received an encounter payment if performed in person, the same service will receive an encounter payment if performed via telemedicine, including telephone and televideo as long as all of the applicable telemedicine requirements are met.
See the waivers and modifications webpage or the Coronavirus (COVID-19) section of the MHCP Provider Manual for more information about requirements that have been waived or modified so together we can continue to provide essential programs and services to Minnesotans safely and without undue delay during the COVID-19 pandemic. (pub. 4/21/20)
The DHS commissioner waived the need for providers to get signatures when delivering DME and supplies to Medical Assistance (MA) and MinnesotaCare members effective Apr. 17, 2020. Providers are required to maintain documentation that they successfully delivered equipment or supplies to members.
Also, effective Apr. 17, 2020, NEMT providers are not required to obtain a signature from MA and MinnesotaCare members to certify that the transport occurred. All other documentation requirements continue to apply and providers are required to ensure appropriate documentation that substantiates that the transport occurred.
This change supports the need for social distancing during the COVID-19 pandemic.
The waiver expires at the end of the COVID-19 peacetime emergency. (pub. 4/21/20)
Minnesota Health Care Programs (MHCP) will post a list of providers approved for telemedicine services and telephonic telemedicine services for COVID-19 expanded services on Apr. 20, 2020. The list, named Telemedicine/Telephonic Telemedicine Provider List, can be accessed by logging in to your MN–ITS account and finding it within the Provider Lists link. The list will be updated each week on Monday and will include all providers approved for telemedicine delivery before the COVID-19 pandemic and those approved to provide services telephonically since the pandemic. You must use a Chrome or Firefox browser and will need the Excel XLSX version to access this list and other provider lists.
Please refer to the Coronavirus (COVID-19) section of the MHCP Provider Manual for more information about telemedicine and telephonic telemedicine services, including billing. (pub. 4/17/20, rev. 4/28/20)
MRRP participants’ COVID-19 related medications will be paid through an acute discharge pharmacy. To assure payment, contact the managed care organization (MCO) of record for the Minnesota Health Care Programs (MHCP) member. If the person is a fee-for-service (FFS) member, contact the MRRP at 651-431-2648 or 800-657-3674 after dispensing medications and give the following information:
Patient name
DOB
PMI (if known)
Diagnosis
Medications dispensed
Prescribing provider and NPI used
Pharmacy name and NPI used
Date of service
When MRRP staff receive a request, they will open the acute discharge pharmacy to allow for claim submission and will call and work with pharmacy staff to ensure reimbursement on active FFS medical assistance patients during this pandemic. (pub. 4/17/20)
On Mar. 20, 2020, Minnesota Governor Tim Walz issued Executive Orders 20-11 and 20-12, granting the Minnesota Department of Human Services (DHS) emergency temporary authority to change administrative and regulatory requirements for state programs in response to the COVID-19 pandemic.
These executive orders aim to ensure access to services and protect the health of over 1 million Minnesotans, including older adults, individuals with disabilities, young families with children and individuals with mental illness—groups likely to be significantly impacted by COVID-19.
Effective Mar. 19, 2020, DHS has removed any cost-sharing for the diagnosis and treatment of COVID-19 for all Medical Assistance (Medicaid) and MinnesotaCare members. This applies to members in both fee for service and managed care.
This action is taken to help address financial concerns that might prevent someone who needs testing or treatment for COVID-19 from seeking appropriate care that would result in an increased risk to public health. The federal government will pay 100 percent of the costs of COVID-19 testing, treatment and the corresponding office visit for Medical Assistance and Minnesota Care.
This executive order and consequent waiver on cost-sharing for COVID-19 remains in effect until the peacetime emergency is terminated or until it is rescinded by proper authority. (pub. 4/10/20)
Minnesota Department of Human Services (DHS) is offering expedited, emergency payments to Minnesota Health Care Programs enrolled nursing facilities providers located in Minnesota for costs directly related to COVID-19 incurred on or after Mar. 13, 2020, per Minnesota Statute 12A.10. That statute allows providers who incur additional costs resulting from disasters to apply for expedited reimbursement.
On Mar. 31, 2020, the Nursing Facility Rates and Policy Division conducted a webinar and PowerPoint presentation which provided instructions for submitting the reimbursement application. That webinar was recorded and is available for those who were unable to participate in the live session. Providers who did not receive the reimbursement application and instruction forms, or who would like a copy of the PowerPoint, can email the Long-Term Care Policy Center at dhs.ltcpolicycenter@state.mn.us.
A frequently asked questions list is being developed and should be posted on the Nursing Facility Provider Portal webpage by the end of April.
Visit the Waivers and modifications webpage and scroll to “Changes under existing authority to respond to COVID-19,” and select No. 3: Expediting payments to nursing homes (CV01) for information on actions taken by the commissioner. (pub. 4/9/20)
WPC is experiencing issues with their website and is working to resolve them. WPC instructs providers to use https://nex12.org/index.php/codes for contact information and access to the X12 codes for the WPC until the WPC webpage is available. We will update this webpage when the WPC issues have been resolved. (pub. 4/3/20)
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)
In response to Gov. Tim Walz’ COVID-19 pandemic Emergency Executive Order 20-12, the Department of Human Services (DHS) has received federal approval to temporarily cover up to a 90-day supply of many noncontrolled prescription maintenance medications.
Under current state law, prescriptions for medications are limited to a 34-day supply (Minnesota Statute, 256B.0625, subdivision 13). Effective April 2, 2020, the DHS commissioner increased the prescription drug coverage limit for certain therapeutic drug classes to a 90-day supply for all fee-for-service Medical Assistance and MinnesotaCare members.
DHS is not mandating that a 90-day supply of these medications be dispensed. Prescribers and pharmacists are expected to continue to use their professional and clinical judgment as to the appropriate quantity to dispense to members.
Claims for medications affected by this change do not require an override from the Provider Call Center. Contact the Provider Call Center to determine if overrides are available for medications not included in this initiative if the member has another insurance that has covered a 90-day supply of the medication. This extension in the prescription drug coverage limit applies to the fee-for-service pharmacy benefit. The managed care organizations (MCOs) may implement a 90-day supply program and you can obtain details of those programs from the MCOs.
This executive order and consequent 90-day supply prescription limit extension for COVID-19 remains in effect until the peacetime emergency is terminated or until it is rescinded by proper authority. (pub. 4/2/20)
Minnesota Health Care Programs (MHCP) is postponing provider revalidation efforts effective Apr. 1, 2020, in accordance with Executive Order 20-12. MHCP will not be sending revalidation notices to providers who are due to revalidate their enrollment to ensure providers remain enrolled and able to provide necessary services to members during the COVID-19 pandemic. We will update the MHCP provider news and updates webpage when the revalidation process resumes. (pub. 4/1/20)
The benefit of attending a C&TC well visit and receiving necessary immunizations and screenings should be balanced with the risk of exposure to other children and adults with potential contagious diseases. Many providers are reviewing their daily workflows and practices in consideration of their patient population, safe practice capacity, clinic environment as well as guidance from the Minnesota Governor’s executive orders. The current American Academy of Pediatrics (AAP) recommendations for providing well visits and immunizations during the COVID-19 Pandemic as of Mar. 19, 2020 are:
Newborn visits or infant weight checks
Well child visits two years of age and younger, of special importance maintaining up to date immunization status
Reschedule well visits for those in middle childhood and adolescence to a later date
See the AAP’s COVID-19 Clinical Guidance Q&A webpage for more information about the AAP’s recommendations. The Minnesota Department of Human Services (DHS) and the Minnesota Department of Health (MDH) recognize that you may prioritize C&TC visits in your practice. The AAP’s recommendations are not intended to replace or supersede institutional policies in place for clinics or health care systems.
See the AAP COVID-19 Clinical Guidance Q&A webpage as well as the Centers for Disease Control and Prevention’s (CDC) Resources for Clinics and Healthcare Facilities webpage to view options to help decrease the spread of COVID-19 with regard to well visits including the consideration of modifications to the structure of the clinic schedule and physical space.
For information specific to managing patients during the COVID-19 outbreak, see the following:
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)
Gov. Tim Walz issued Executive Order 20-12 Mar. 20, 2020, and DHS Commissioner Jodi Harpstead has suspended or modified certain licensing requirements and activities until May 1, 2020, to allow greater flexibility to comply with recommendations from the Minnesota Department of Health and the Centers for Disease Control and Prevention. These modifications ensure the best interests of your clients and communities are met.
CMS has developed an additional code for coronavirus lab tests effective Apr. 1, 2020. See the CMS Develops Additional Code for Coronavirus Lab Tests CMS newsroom webpage for code information. Beginning Apr. 1, 2020, providers may submit claims for tests performed on or after Feb. 4, 2020.
We follow CMS and CDC guidelines and we are working on updating our system to be ready for claims submitted beginning Apr. 1, 2020. Continue to monitor this webpage for updates.
We have compiled a list of non-Minnesota Department of Human Services (DHS) learning sessions on using telecommunications technology as a response to the COVID-19 pandemic and evolving concerns with service providers in the field of mental health and substance use disorder. For learning sessions information, schedule and topics, see the following:
Telehealth Learning Series for SUD Tx and Recovery Support Providers – The Addiction Technology Transfer Center (ATTC) Network, the Center for Excellence on Protected Health Information (CoE-PHI), the National Consortium of Telehealth Resource Centers, and the Center for the Application of Substance Abuse Technologies (CASAT) at the University of Nevada – Reno facilitate this training. Visit the Telehealth Learning Series for SUD Tx and Recovery Support Providers webpage for more information.
TLC Tuesdays (5 sessions) – Mid-America Mental Health Technology Transfer Center (MHTTC) offers online training.
Complete recordings from each session will be available on the Telehealth Learning & Consultation Tuesdays webpage.
The DHS Coronavirus Disease 2019 (COVID-19) webpage provides counties, tribes, providers and members of the public with information specific to responding to COVID-19 as it relates to DHS programs. You can also sign up to receive email updates on that page. Check the webpage often as it will be updated as additional waivers are approved. (pub. 4/3/20)
Minnesota Health Care Programs (MHCP) offers free online training for MHCP enrolled providers. Go to the MHCP enrolled provider training webpage to see the list of available training.
We have added new training sessions for the following service providers:
