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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.
We will update this section with information about MN–ITS availability, technical information and other systems announcements when necessary.
Minnesota Department of Human Services will host two webinars to discuss the upcoming request for proposals for the next round of State Opioid Response (SOR) grants.
Minnesota has received funds for 2020 and 2021 from the Substance Abuse and Mental Health Services Administration to help address the opioid crisis by:
This is the next round of SOR grants, building on the work that is currently underway. However, new and smaller providers are especially encouraged to apply.
There will be two webinars, one for providers serving Greater Minnesota and one for providers serving the metro area.
Greater Minnesota providers webinar
Wednesday, Oct. 28, 4 p.m. until 6 p.m.
Metro area providers webinar
Thursday, Oct. 29, 4 p.m. until 6 p.m.
Visit the State Opioid Response 2020 grant informational meetings webpage for meeting access information. (pub. 10/21/20)
Waiver Reimagine streamlined service changes are designed to simplify the disability waiver service menu by combining similar services across the waivers and make the disability waiver system easier to understand.
The changes affect the following disability waiver programs:
These changes do not include elderly waiver.
In December of 2020, the Department of Human Services’ Provider Eligibility and Compliance team will begin updating existing provider enrollment records for Waiver Reimagine service changes, which will go into effect Jan. 1, 2021, or upon federal approval, whichever is later.
No action is needed from providers who are currently enrolled in any of the following services:
Members who access services through a disability waiver will receive the Waiver Reimagine streamlined service changes beginning Jan. 1, 2021, or upon federal approval. The streamlined services will be authorized at a member’s annual reassessment or a change in service plan after Jan. 1, 2021.
Billing requirements for the Waiver Reimagine streamlined services will not change.
See the Waiver Reimagine webpage for more information about the Waiver Reimagine project changes or the Disability Services Division training archive webpage to view previously recorded webinars about the Waiver Reimagine project. (pub. 10/20/20)
A Minnesota team of interagency professionals is hosting a series of webinars to help increase awareness and access to the range of services and supports available to people with autism spectrum disorder (ASD) throughout their lifetime. The series begins Nov. 2, 2020. Representatives from the following agencies and organizations will present information and answer your questions:
We will also review how services and supports for autism and related conditions are being provided or adapted during the COVID-19 public health emergency.
See the Pathway to autism services and supports webinar series DSD eList announcement for registration and more information. (pub. 10/20/20)
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)
Minnesota Health Care Programs (MHCP) recommends all providers sign up to be paid through EFT or direct deposit. EFT payments are a convenient alternative to receiving paper checks and feature many advantages.
EFT payments are:
Providers who want to be paid through EFT from MHCP must have a vendor number from Minnesota Management and Budget (MMB).
Follow these steps to establish a vendor number for MHCP payments:
(pub. 10/14/20, rev. 10/22/20)
The Waiver Reimagine project team hosted a webinar on Oct. 13, 2020, about upcoming changes to Minnesota’s waiver programs to streamline the service menu. We have gathered your feedback through stakeholder input events and have received many questions about the process. The webinar provides an update on the streamline service menu changes, the operational status of the project and reviews some of the common questions.
An audio recording of the Oct. 13 webinar will be available on the Disability Service Division training archive webpage after Oct. 14, 2020.
See the Waiver Reimagine: Implementing the streamline service changes eList announcement for detailed information about the webinar. (pub. 9/22/20, rev. 10/13/20)
Effective Aug. 1, 2020, Minnesota Health Care Programs (MHCP) will allow Minnesota public schools enrolled to provide Individualized Education Program (IEP) services and also approved to provide telemedicine services, to use store-and-forward telemedicine when a child is distance learning at home for the following services:
Store-and-forward telemedicine is asynchronous, non-real-time communications. Data is transferred from one site to another through the use of a camera or similar device that records (stores) an image that is sent (forwarded) via telecommunications to another site for consultation. It can be used to support health care delivery, including sending and receiving health-related instructions, activities or tasks that are identified in the child’s Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP) that are necessary to maintain, restore or improve functions related to the child’s disability.
To be reimbursed by MHCP, the store-and-forward telemedicine component must be accompanied by some real-time, two-way interactive video with the school professional and child or parent.
The store-and-forward method can only be used when a child is distance learning at home. When a child is attending school in person, IEP services must be provided either in person, or via two-way interactive video conference.
IEP nursing services, special transportation, assistive technology and personal care assistance (PCA) services are not eligible for store-and-forward telemedicine.
This waiver will remain in effect until the end of the public health emergency, or July 1, 2021, whichever comes later. (pub. 10/13/20)
Behavioral Health Division has scheduled informational sessions to prepare SUD providers for direct access process and service billing. The sessions will be held via Webex on Oct. 14, 2020, from 10:30 a.m. until noon and on Oct. 19, 2020, from 8:30 a.m. until 10 a.m. You can attend a session five minutes before its start time using one of the following ways:
(pub. 10/12/20)
The Minnesota Department of Human Services (DHS) is asking existing users of the Minnesota Provider Screening and Enrollment (MPSE) portal to participate in a survey designed to evaluate the performance of this online enrollment portal and determine if any features can be improved.
The MPSE portal enables providers to submit and manage their MHCP provider enrollment records and related enrollment requests. MPSE is available to all MHCP providers, electronic data interchange (EDI) trading partners, clearinghouses and billing intermediaries. We have auto-populated the information from our enrollment files so when you become an MPSE user, you can immediately begin to manage or initiate updates to your enrollment information.
This survey does not request identifying information. Summary data is public data and may be shared with anyone.
Please access the survey here: Minnesota Provider Screening and Enrollment (MPSE) Portal User Survey (pub. 10/6/20)
HHS Secretary Alex M. Azar again renewed the COVID-19 public health emergency effective Oct. 23, 2020, through Jan. 21, 2021. See the HHS’ Renewal of Determination That A Public Health Emergency Exists webpage to read the official declaration of this renewal. (pub. 10/5/20)
The Minnesota Department of Human Services Office of the Inspector General has selected Myers and Stauffer LC to provide RAC services. Myers and Stauffer is a highly experienced accounting and consulting firm providing services to state and federal government entities and has served as the Medicaid RAC in several states.
The RAC began reviews in September and will be requesting records from various Minnesota Health Care Programs (MHCP) providers and reviewing paid MHCP claims to identify claims paid as a result of fraud, waste and abuse.
See the Minnesota Medicaid RAC webpage on the Myers and Stauffer website for access to a secure portal and additional information.
You may also call the RAC at 844-987-0492 Monday through Friday, 8 a.m. until 4:30 p.m. or email mn_rac@mslc.com if you have questions about the audit. (pub. 10/5/20)
U.S. Department of Health and Human Services (HHS) announced $20 billion in Phase 3 provider relief funding will be released to providers on the front lines of the COVID-19 pandemic. Under Phase 3, providers who have already received Provider Relief Fund payments may apply for additional funding. Previously ineligible providers, including those who started practicing in 2020, and a wider group of behavioral health providers are also eligible. You may apply for Phase 3 funding beginning Oct. 5, 2020, through Nov. 6, 2020. See the Trump Administration Announces $20 Billion in New Phase 3 Provider Relief Funding news release on the HHS website for more information about Phase 3 and the Provider Relief Fund. (pub. 10/2/20)
Minnesota Health Care Programs (MHCP) providers may not charge members for the cost of personal protective equipment (PPE) or other costs related to COVID-19. If you need PPE supplies for your facility, please see Minnesota’s PPE Requests website for more information.
All MHCP providers who submit service claims for a person enrolled in an MHCP major program are required to follow all MHCP provider requirements, including MHCP billing policy.
MHCP Reimbursement is Payment in Full
A provider must accept MHCP reimbursement as payment in full for covered services provided to a member. A provider may not request or accept payment from a member, a member's relatives, the local human services agency, or any other source, in addition to the amount allowed under MHCP unless the request is for one of the following:
See the Billing the Recipient section of the MHCP Provider Basics for more information about allowable billing practices for MHCP programs. (pub. 9/29/20)
Personal frequency modulation (FM) systems and individual assistive listening devices listed on the 2020 Hearing aid contract, vendors, models, prices and codes Effective 9/1/20 through 8/31/21 (PDF) no longer require authorization effective Sept. 1, 2020. Bill FM complete systems using codes V5281 or V5282 with an NU modifier and the correct model number. Include an attachment listing the individual component’s model name, model number and price. The line amount billed must equal the cost of the individual components in the system. Do not bill multiple individual FM components using HCPCS codes V5283 through V5290 on the same claim because they will deny due to National Correct Coding Initiative conflicts. (pub. 9/22/20)
The Minnesota Department of Human Services (DHS) will deny Housing Stabilization Services Eligibility Request (DHS-7948) if the attachments section of the form is incorrectly completed effective Oct. 1, 2020. We require submission of approved eligibility documentation in the appropriate attachment categories for system purposes (Disability, Assessment and Person-Centered Plan).
We will deny the request if a document is uploaded into the wrong attachment category. For example, if the Professional Statement of Need is uploaded into the Person-Centered Plan category, DHS Eligibility Review Staff will deny the request. The only exception is when the Coordinated Services and Supports Plan or Coordinated Care Plan is separated and uploaded into the Person-Centered Plan and Assessment categories due to file upload size limitations (uploads cannot exceed 5MB per document).
We recently issued Allowed Documentation for Housing Stabilization Services Eligibility Requests (PDF) guidance to assist providers in completing DHS-7948. It is also located on the Housing Stabilization Services policy webpage. Contact the DHS Housing Stabilization Services team at dhshousingstabilization@state.mn.us if you have questions about this message. (pub. 9/22/20)
Claims using procedure code H2015 since Aug. 31, 2020, may have been denied due to a technical issue. We have resolved the issue and reprocessed the claims. The reprocessed claims appeared on the Sept. 15, 2020, remittance advice (RA). Call the Minnesota Health Care Programs Provider Call Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 9/15/20)
Minnesota Department of Human Services sent IEP interim rates for fiscal year 2020-2021 to school district’s MN–ITS mailboxes Sept. 15, 2020.
IEP interim rates for July 1, 2020, through June 30, 2021, have been calculated based on actual time and encounter data submitted by school districts and final data information from the Minnesota Department of Education from fiscal year 2018-2019.
You will find your document in the Miscellaneous Received folder in your MN–ITS mailbox under File Type – IEP. It is named Interim Rates for FY20-21. Contact Jesusa Williams at 651-431-2538 or email her at Jesusa.Williams@state.mn.us if you have questions about this message. (pub. 9/15/20)
Minnesota Department of Health (MDH) has announced changes to licensing and certification processes for home care and housing with services.
Home care licenses that expired in good standing on or after Apr. 1, 2020, are considered in effect until the licensee has been notified otherwise by MDH. Minnesota Health Care Programs (MHCP) will continue to process claims billed as usual.
Housing with services applications and renewals are currently being processed in the order they were received. See the following resources for information about home care license or housing with service registrations:
Call MDH at 651-201-4101 if you have questions about MDH license and registration renewal suspension.
Call the MCHP Provider Call Center at 651-431-2700 or 800-366-5411, option 4, if you have questions about MHCP billing and claims. (pub. 9/15/20)
Minnesota Health Care Programs (MHCP) updated its system Aug. 19, 2020, to resolve disruptions to service agreements and claims that denied due to a July 22, 2020, system update. Claims denied July 22, 2020, through Aug. 19, 2020, with remark code M143 on HCBS providers’ remittance advices that have not been rebilled will be reprocessed and appear on the Sept. 15, 2020, and the Sept. 29, 2020, remittance advices. (pub. 9/14/20, rev. 9/29/20)
The Minnesota Department of Human Services (DHS) is seeking providers familiar with delivering telemedicine to participate in a focus group. The focus group will examine the effectiveness of telemedicine delivery before and during the public health emergency. The results of the analysis will help DHS make recommendations about the future of telemedicine in Minnesota and coverage under the state’s public health care programs. See the Request for Providers to participate in telemedicine effectiveness focus groups Behavioral Health e-Memo for information about the focus group and how to participate. (pub. 9/9/20)
Minnesota Health Care Programs (MHCP) will not accept modifier UD with HCPCS K0108 beginning Sept. 1, 2020. This modifier and code combination has been used for professional services associated with custom-molded seating and backs. See the Mobility Devices section of the MHCP Provider Manual for information about pricing documentation for custom fabricated seating. (pub. 8/18/20)
The Minnesota Department of Human Services (DHS) received notification from the Centers for Medicare & Medicaid Services (CMS) that the federal public health emergency was extended on July 24, 2020, for an additional 90 days.
What this means for Housing Stabilization Services:
CMS will notify DHS when the COVID-19 public health emergency has ended. DHS will notify Housing Stabilization Services providers that home and community-based services requirements have been reinstated and provide a timeline for compliance when the public health emergency ends.
Provider enrollment is now open. See the Housing Stabilization Services section of the Minnesota Health Care Programs Provider Manual and the Housing Stabilization Services policy manual for more information about the service. Email dhshousingstabilization@state.mn.us if you have questions about this service. (pub. 8/14/20)
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)
Effective July 13, 2020, licensed day service facilities can reopen to people who live in any setting and receive day training and habilitation (DT&H), prevocational services or structured day services, as long as the facility follows Preparedness Plan Requirements Guidelines for DHS Licensed or Certified Nonresidential Services Deemed Critical Businesses during Peacetime Emergency (PDF).
This guidance does not apply to adult day services. Guidance specific to alternatives and modifications for adult day services are included in Bulletin #20-25--01, Alternative adult day service delivery due to COVID-19 pandemic (PDF) and the Temporary modifications to adult day center licensing requirements on the DSD COVID-19 Updates page.
DHS published Bulletin #20-56-07, Turning the dial on day services for adults with disabilities (PDF) to provide lead agencies and waiver day service providers with guidance on how to:
For additional information on service authorizations, rates and policy, review the Disability services COVID-19 frequently asked questions page. (pub. 7/21/20)
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 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:
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)
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:
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 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:
See the Guidance for PCA agencies and other agencies providing in-home support during the COVID-19 emergency webpage to see the information and recommendations. (pub. 6/18/20)
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:
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.
See revised Bulletin 20-25-02 Customized living rate add-on payments for settings with confirmed cases of COVID-19 for more information about eligible providers and claims, rate add-on payments, terms and conditions of payments, meeting the needs of individual waiver members and more. (pub. 6/18/20, rev. 7/6/20)
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:
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.
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:
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:
See information about this added to the Coronavirus (COVID-19) section of the Minnesota Health Care Programs Provider Manual. You may also read Bulletin 20-25-01 Alternative adult day service delivery due to COVID-19 pandemic (PDF) for more information about the delivery method and delivery location of these services, revised licensing requirements and other changes. (pub. 5/20/20)
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:
(pub. 5/19/20)
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.
Psychiatric care providers must submit the Telephonic Telemedicine Provider Assurance Statement (DHS-6806A) (PDF) to temporarily provide services via telephone or tele-video. Your “Requested Service Effective Date” on the form can be on or after Mar. 19, 2020.
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.
Fee-for-service providers:
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.
Policies on telemedicine services are in the Physician and Professional Services section of the MHCP Provider Manual.
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.
Email DHS at dhs.childteencheckups@state.mn.us if you have questions about this message. (pub. 4/24/20)
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:
Revised Bulletin #20-69-02 Targeted case management changes for face-to-face contact requirements includes temporary instructions for these services. (pub. 4/22/20, rev. 7/1/20)
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:
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:
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:
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:
Email the C&TC programs at DHS at dhs.childteencheckups@state.mn.us or MDH at health.childteencheckups@state.mn.us if you have questions or need more information about prioritizing well child visits.
This is a collaborative communication from the Child and Teen Checkups teams at DHS and MDH. (pub. 4/1/20)
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)
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.
Read the COVID-19 update regarding Minnesota Department of Human Services (DHS) licensing message to find out more about DHS suspending or modifying most licensing enforcement activity. (pub 3/24/20)
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.
The American Medical Association (AMA) also approved a unique CPT code effective Mar. 13, 2020. See the AMA’s New CPT Code Announced to Report Novel Coronavirus Test press release. The Centers for Disease Control and Prevention (CDC) has issued coding guidelines for COVID-19. See the CDC’s ICD-10-CM Official Coding Guidelines - Supplement (PDF) for more information.
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.
Additional COVID-19 resources
(pub.3/18/20)
Minnesota Health Care Programs (MHCP) offers free training for MHCP enrolled providers.
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 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 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)
Minnesota Health Care Programs (MHCP) is offering free Minnesota Provider Screening and Enrollment (MPSE) portal training for providers who want to provide Housing Stabilization Services. Training sessions are scheduled for both Housing Access Coordination providers and other MHCP-enrolled providers and will be held via webinar.
Training for HAC providers:
Training for other MHCP-enrolled providers:
See the Minnesota Provider Screening and Enrollment Portal (MPSE) Training for Housing Stabilization Services webpage for registration and other information. (pub. 10/9/20)
Visit the following for more information:
If you have questions about this information, call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411.
Sign up to receive provider news and other MHCP notices through our free provider email lists.
