MHCP provider news and updates

We will upgrade to the Excel XLSX version from the Excel XLS version beginning Apr. 22, 2019, for lists or reports posted in MN–ITS. If you need to open those files, you will need the Excel XLSX version. (pub. 4/16/19)

You may see duplicate X12 835 RAs in your MN–ITS mailbox on the Mar. 19 and Apr. 2, 2019, warrants. The data in the original is the same as the data in the duplicate. You can ignore the duplicate RAs. (pub. 3/21/19, rev. 4/3/19)

The Institute for Community Inclusion at the University of Massachusetts Boston is accepting applications for the Minnesota technical assistance project (MN-TAP). This project will help you offer better support to people with intellectual and developmental disabilities as they receive and succeed in competitive, integrated employment opportunities. See the Minnesota Technical Assistance Project (PDF) for more information about the project.

MN-TAP is hosting a webinar on Tuesday, Apr. 2, 2019, at 3 p.m. for you to learn about the project and ask questions. See the DSD eList announcement for registration and more information. (pub. 3/28/19)

With February's record snowfall and March's warmer temperatures, many parts of Minnesota are at a higher risk of flooding. Minnesota Department of Human Services (DHS) will work with lead agencies and waiver service providers in preparation and response. For information on eligible reimbursements for relocating people who receive waiver (DD, CAC, CADI, BI and EW) and Alternative Care program services, see the DSD eList: Community emergency and disaster assistance protocols for people who receive waiver services announcement. (pub. 3/22/19)

We invite you to join disability employment expert Genni Sasnett this April for a free one-day training session “Transforming Organizations to Transform Services.” The training focuses on the organizational changes required to support innovation and transformation in the areas of employment and community integration. Training will be held in Duluth, Mankato and West St. Paul. See the DSD eList announcement webpage for dates, locations, registration and more information. (pub. 3/21/19)

Minnesota Health Care Programs (MHCP) will take back CSG claims submitted with procedure code T2025 and the 76 modifier going back to July 1, 2018. This will occur on the Apr. 16, 2019, warrant. The 76 modifier is used for repeat procedures or services by the same physician or other qualified health care professional and is 50 percent state funded and 50 percent federally funded. The CSG program is 100 percent state funded.

Providers with claims taken back for this reason on the Apr. 16, 2019, warrant should rebill these claims without the 76 modifier. (pub. 3/19/19)

We revised the requirements for mental health practitioners providing services to MHCP members effective May 12, 2018.

See the General MHCP Non-Enrollable Mental Health Provider Requirements section of the MHCP Provider Manual for more information. (pub. 3/14/19)

The current mental health fee-for-service CPT or HCPC procedure codes and rates are now updated effective Jan. 1, 2019. See the Service rates information webpage for code and rate information. (pub. 3/13/19)

Minnesota law requires the Minnesota Department of Human Services (DHS) to provide individualized Opioid Prescribing Reports to all health care providers who treat Minnesota Health Care Programs (MHCP) members and prescribe opioids for pain management. This includes health care providers who only care for MHCP members enrolled in a Managed Care Organization (MCO).

DHS will send the first individual Opioid Prescribing Reports to your MN–ITS mailbox this spring. The Opioid Prescribing Reports are private data; we will provide them only directly to you, the health care provider. The report compares your prescribing data to your peers in your specialty. The only provider-specific information will be about your prescribing. You will receive a report only if you prescribe opioids.

To access the report, providers must register for a MN–ITS account. MN–ITS is the free, web-based HIPAA-compliant system for electronic billing and communication with providers. DHS will send MN–ITS registration letters with user IDs and temporary passwords to all opioid-prescribing providers who do not currently have a MN–ITS account, via U.S. Postal Service, in late March or early April. Please watch for this letter and notify your administrative staff or billing office to watch for it and route it to you so you can register your account.

Training on how to access the report in your MN–ITS mailbox will become available before the release of the reports. We will provide a link to the training on this webpage and the Opioid Prescribing Improvement Program website when the training becomes available.

The Opioid Prescribing Reports will support the DHS Opioid Prescribing Quality Improvement Program. See the Opioid Prescribing Improvement Program website for more information.

Contact the MHCP Provider Call Center at 651-431-2700 or 800-366-5411 for questions about your MN–ITS mailbox. Direct questions about the Opioid Prescribing Reports to dhs.opioid@state.mn.us. (pub. 3/8/19)

Prior authorization is required for claims for repair or replacement of wheelchair parts or accessories if the submitted combined charges for parts and labor are $1,000 or more. This applies to fee-for-service only. Claims without prior authorization are subject to payment recoupment beginning with a date of service of July 1, 2018. You may resubmit denied claims with authorization within one year of the date of service. See the Mobility Devices section of the Minnesota Health Care Programs (MHCP) Provider Manual for more information. (pub. 3/8/19, rev. 3/19/19)

The Department of Human Services (DHS), in collaboration with the medical community, developed a new educational campaign to change the narrative around prescription opioid therapy, pain management and prescription opioid misuse. The Flip the Script outreach program increases awareness about safe opioid prescribing behavior and arms you with the tools and resources you need to talk with your patients about opioids and pain management. It also includes an online learning activity allowing you to earn continuing education credits for learning more about safe opioid prescribing behavior guidelines.

Visit the Flip the Script Opioid Prescribing Improvement Program website to learn more about the Opioid Prescribing Improvement Program. (pub. 3/7/19)

The Minnesota Department of Human Services (DHS) allows the use of R diagnosis codes R45-R45.89 for outpatient psychotherapy and psychoeducation sessions beginning Feb. 5, 2019. See the ICD10Data Symptoms and signs involving emotional state webpage for R45-R45.89 code information.

R code rationale:

• R codes help the clinician focus on symptomology without committing to a diagnosis. They describe the functional impact but not necessarily the cause. R codes would be inappropriate for extremely long time periods, but could establish the medical necessity for further engagement, treatment and refined diagnosis.
• R codes will help acknowledge and explore cultural context in some symptomology.

R codes cannot be used for sessions that require a diagnosis of a serious and persistent mental illness (SPMI) or severe emotional disturbance (SED).

See the ICD10Data Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified webpage for more information about R codes. (pub. 3/5/19)

Minnesota Department of Human Services (DHS) has extended the deadline to Jan. 1, 2021, for current DBT IOP providers enrolled in Minnesota Health Care Programs (MHCP) to become certified through a national certification board approved by the DHS Commissioner. See the Dialectical Behavior Therapy Intensive Outpatient Program – National Certification provider news published May 19, 2017, for more information. (pub. 3/5/19)