MHCP provider news and updates

Refer to the EIDBI licensing news and updates DSD eList announcement for information and resources about new provisional licensing requirements for all enrolled EIDBI agencies, as directed by the 2025 Minnesota Legislature. We will gather provider feedback and work with the EIDBI Advisory Council to develop full licensing standards and update you when we have more information. (pub. 8/14/25)

The Minnesota Department of Human Services (DHS) requests public comments on amendments to the Elderly Waiver (EW) plan before submitting the amendments to the Centers for Medicare & Medicaid Services for approval. Submit comments to AASD.Publiccomments@state.mn.us by 4 p.m. Friday, Sept. 12, 2025. 

Review the DHS requests public comments on EW plan amendments Aging and Adult Services Division eList announcement for more information. (pub. 8/13/25)

The Minnesota Department of Human Services is offering a training session for EIDBI providers on how to manage a change of ownership, including how to properly submit the Provider Entity Sale or Transfer Addendum (DHS-5550) and other required documents. The session will cover timelines, credentialing steps, and how to avoid billing or enrollment disruptions during ownership transitions.

The online training session is scheduled for Wednesday, Sept. 10, 2025, from 9 to 10 a.m. Registration is required.

Refer to the Training announcement: Understanding Change of Ownership: What Early Intensive Developmental and Behavioral Intervention (EIDBI) Providers Need to Know Disability Services Division announcement for more information and to register. (pub. 8/13/25)

On Friday, Aug. 1, the Minnesota Department of Human Services (DHS), on the guidance of its own DHS Office of Inspector General, moved to terminate the Housing Stabilization Services program due to large-scale fraud found by OIG's data analysis and investigatory work.

We know this news brings up many questions for HSS providers and clients, especially about the timeline for termination and whether providers can continue providing services for the time being. DHS has compiled an Housing Stabilization Services program termination FAQ webpage for HSS providers and clients that contains all of the information available at this time.

Terminating the entire HSS program is a complex action involving numerous parties, and it cannot be immediately enacted. Until then, eligible HSS providers can continue to deliver services to enrolled individuals and individuals may continue applying to the program at this time.

This is a developing situation and DHS will update the FAQs and communicate with providers as more information is received.

We are hearing that there is confusion between Housing Support and Housing Stabilization Services. It might be helpful to clarify whenever possible that these are two separate programs:

• Housing Stabilization Services helps a person find and keep housing.
• Housing Support (formerly known as Group Residential Housing or GRH) is a resource for adults with low incomes who have a disability or are 65 or older that helps eligible recipients pay for their housing costs. Counties and some tribes administer the Housing Support program for the state and are responsible for determining eligibility.

(pub. 8/12/25)

We have updated the claim adjustment group code and claim adjustment reason code related to the Medicare Economic Index (MEI) adjustment as it appears on the remittance advice for mental health services.

Previously, this adjustment was reported as “OA 209.” It has now been corrected to “CO 144,” which more accurately reflects the nature of the adjustment.

Note: This is a reporting correction only. There is no impact on claims or claim payments. We will not be reprocessing any claims because of this update.

Contact the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 with any questions. (pub. 8/7/25)

The Minnesota Department of Human Services (DHS) is implementing new requirements for EIDBI individual providers. 

Effective Aug. 5, 2025, EIDBI providers must have a complete DHS background study (BGS) through NetStudy 2.0 (NS2) with an “eligible” or “set-aside” result before they provide services.

  What providers must do

• New EIDBI individual providers, reenrolling and revalidating providers must include their BGS ID or Application ID from the NS2 system in the notes section in MPSE. If submitting by fax, enter the NS2 BGS ID or the Application ID in the Individual Provider Personal Profile section of the Individual Provider Enrollment Application (DHS-4016) (PDF).
• EIDBI individual providers affiliated with an EIDBI agency require a new BGS. Include the BGS ID or Application ID from the NS2 system in the Notes section of the affiliation request in MPSE. The request will be returned to the provider if this information is missing.
  If submitting by fax, you must enter the NS2 BGS ID or Application ID in the Individual Provider Personal Profile section of the Individual Provider Enrollment Application (DHS-4016) (PDF), complete and submit the Fee-for Service (FFS) only or FFS and Managed Care Organization In-Network Provider Agreement (DHS-4138) (PDF) and the following applicable forms:
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Qualified Supervising Professionals (QSP) Assurance Statement (DHS7120C) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level I Provider Assurance Statement (DHS-7120D) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level II Provider Assurance Statement (DHS-7120E)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level III Provider Assurance Statement (DHS-7120F)

Form changes

• The MHCP Individual Provider Profile Change (DHS-3535) (PDF) is no longer accepted to add EIDBI affiliations.
• Starting Aug. 5, 2025, the MHCP Individual Provider Profile Change (DHS-3535) (PDF) may only be used to:
  • End an affiliation
  • Submit a name change
  • Add a National Provider Identifier (if the provider previously had a Unique Minnesota Provider Identifier (UMPI)

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 8/7/25)

Beginning July 1, 2025, MHCP will require providers to submit the new Recuperative Care Surety Bond (DHS-8748) before submitting the application to enroll as an RE provider. 

Providers should know the following:

The Recuperative Care Surety Bond (DHS-8748)

• The Recuperative Care Surety Bond (DHS-8748) will be available soon. It will be posted on Recuperative Care Enrollment Criteria and Forms when available.
• The surety bond must be in the amount of $50,000 for first-time enrolling providers. 
• MHCP does not provide a list of surety bond companies to consider. It is the provider’s responsibility to find a surety bond company to work with. 

Received on or after July 1, 2025: All enrollment applications

• Providers need to complete and comply with the new requirements including the Recuperative Care Surety Bond (DHS-8748). We will process applications after MHCP receives the completed Recuperative Care Surety Bond (DHS-8748). 

Received before July 1, 2025: Approved or complete enrollment applications

• Providers do not need to submit the surety bond at this time. The Minnesota Department of Human Services will notify providers when they need to submit the surety bond.

Received before July 1, 2025: Incomplete enrollment applications

• Providers need to complete and comply with the new requirements including the Recuperative Care Surety Bond (DHS-8748).

We will post a message on this webpage when updates are available. (pub. 8/6/25)

The Minnesota Department of Human Services (DHS) has sent providers who attended the entire Community First Services and Supports (CFSS) Steps for Success workshop on June 25-27, 2025, their certificates of completion. 

DHS sent the certificates to the email address used to register for the June CFSS Steps for Success workshop. Providers who completed the entire training should have received their certificate by the end of the business day Aug. 4, 2025. 

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 8/4/25)

The Minnesota Department of Human Services (DHS) is accepting proposals from qualified respondents interested in becoming a Community First Services and Supports (CFSS) consultation services provider. Review the July 29, 2025 eList announcement or visit our open grants, RFPs and RFIs webpage for information and instructions on how to submit a proposal. Interested respondents must submit their proposal by 4 p.m. on Aug. 29, 2025. (pub. 8/4/25)

We have revised this message to include level 1 and 2 providers in the monthly observation requirements and limits on telehealth use. The Minnesota Legislature has passed new clinical supervision requirements for qualified supervising professionals (QSPs) for Early Intensive Developmental and Behavioral Intervention (EIDBI) services, effective Jan. 1, 2026. Key changes include minimum supervision ratios for QSPs, monthly QSP, level 1 and 2 provider observation requirements, and limits on telehealth use for QSP, level 1 and 2 provider supervision.

Refer to the New EIDBI clinical supervision requirements DSD eList announcement to review the requirements. (pub. 7/30/25, rev. 8/14/25)

The Minnesota Department of Human Services (DHS) recently reprocessed personal care assistance (PCA) and Community First Services and Supports (CFSS) tiered rate claims with dates of service of Jan. 1, 2025, through the current date. As a result, PCA and CFSS agency model providers will see longer than usual remittance advice (RA) reports for warrant cycles over the next 30-45 days. Providers are not required to print their RA reports. 

DHS reprocessed these claims because the system was subtracting payments at the tiered rate amount instead of the base rate amount from the service authorization. 

Due to the reprocessing, some claims with the adjustment reason code 273 on your RA did not pay at the correct amount. DHS will reprocess those claims to correct the payment on a future remittance advice. 

Providers do not need to take any action on the reprocessed claims.

Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with any questions. (pub. 7/29/25)

Minnesota Health Care Programs (MHCP) amended authorization requirements for several mobility device HCPCS codes effective Aug. 1, 2025. 

MHCP is changing authorization from sometimes required to always required for wheelchair transportation and transit securement systems and miscellaneous items under the Mobility Devices section of the MHCP Provider Manual. The following HCPCS codes now require authorization always, regardless of submitted charge: 

• E1022: Wheelchair transportation securement system, any type, includes all components and accessories
• E1023: Wheelchair transit securement system, includes all components and accessories
• K0108: Wheelchair component or accessory, not otherwise specified

Refer to Authorization information in the Mobility Devices section of the MHCP Provider Manual for HCPCS codes listed as always requiring authorization. 

Under the Noncovered Services section, we added a list of accessories under items of convenience. These items are typically noncovered services. Items that address a medical condition should be coded as HCPCS code K0108. MHCP considers these items to be convenience items if they are not requested for the member’s specific medical condition. Items only for convenience should be coded as HCPCS code A9270. 

Providers must note the reason for requesting HCPCS codes where authorization is sometimes required. These include requests for excess quantities, backup manual wheelchairs, or devices for members who live in a nursing facility. Providers must clearly identify and explain this in documentation submitted to the medical review agent. 

Providers must bill two claims when billing MHCP: one for codes that do not require authorization, and one for codes that do require authorization. 

Review the Mobility Devices section of the MHCP Provider Manual and the Medical Supply Coverage Guide (PDF) for information on MHCP authorization requirements and quantity limits by HCPCS code. Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 7/25/25)

Minnesota Health Care Programs has identified Medicare crossover claims where a 3 percent mental health rate increase was incorrectly applied when Medicare paid only the deductible or coinsurance. We have started reprocessing the affected claims to recoup overpayment. The reprocessed claims will appear on your Aug. 1, 2025, remittance advice. Providers do not need to take any action. (pub. 7/23/25)

The Minnesota Department of Human Services is offering EIDBI Clinical Supervision trainings to help providers understand supervision requirements, responsibilities, and best practices. These sessions are designed to help EIDBI providers prepare to implement the new clinical supervision requirements passed during the 2025 legislative session.

The online training sessions are scheduled for the following dates and times:

• Wednesday, Aug. 20, 2025, from 9 to 10:30 a.m.
• Wednesday, Sept. 17, 2025, from noon to 1:30 p.m.

The content is the same for both training sessions. Registration is required.

Refer to the Training announcement: EIDBI Clinical Supervision Trainings Disability Services Division training announcement for more information and to register. (pub. 7/23/25)

Partial hospitalization services rendered Jan. 1, 2024, through June 30, 2024, will receive a payment increase of 3 percent from the rates in effect as of Dec. 31, 2023. The rate increase is based on Minnesota Statutes, 256.761, subdivision e. Partial hospitalization was not approved for the three percent rate increase until July 1, 2024. 

The Minnesota Department of Human Services will reprocess claims for the affected dates as a  gross adjustment payment for the increased rate. You do not need to take further action while we make these claims adjustments. The adjustments will appear on your Aug. 1, 2025, remittance advice. (pub. 7/22/25)

The 2025 Minnesota Legislature extended the use of audio-only telehealth services by providers to July 1, 2027. Audio only is the delivery of health care services or consultations through telephone communication while the patient is at one site and the qualified health care provider is at a distant site. Refer to the Telehealth Services section of the Minnesota Health Care Programs Provider Manual for more information. (pub. 7/16/25)

Effective Aug. 5, 2025, EIDBI agency owners, operators, and direct service staff must complete a Minnesota Department of Human Services background study through NETStudy 2.0; and receive an eligible or set-aside result before providing EIDBI services. The requirement results from changes passed by the 2025 Minnesota Legislature. 

Refer to the EIDBI background study requirement updates DSD eList announcement for a summary of the changes.

We will share more information and resources in future eList announcements, Minnesota Health Care Programs Provider Manual updates, and on this webpage. (pub. 7/15/25)

The following are changes coming to the health care plans available in counties for the Prepaid Medical Assistance Program (PMAP) and MinnesotaCare. 

For PMAP and MinnesotaCare members
Effective Sept. 1, 2025, UCare will no longer be available in the following counties for Prepaid Medical Assistance Program (PMAP) and MinnesotaCare:

For MinnesotaCare Members Only
As of July 1, 2025, Medica became available in Benton, Ramsey and Stearns counties for MinnesotaCare.

Effective Aug. 1, 2025, Medica will expand for MinnesotaCare only into the following counties:

For PMAP Members Only
Effective Sept. 1, 2025, Medica will be expanding for PMAP only into Benton and Kanabec counties.

Members Notified
The Minnesota Department of Human Services sent letters out to members notifying them of this change July 1-3, 2025. Members will need to choose a different plan available in their county. Refer members to our Maps online.   

Providers must work directly with the members new managed care organization (MCO) for contracting information. Refer to MCO Contacts for MHCP providers.

If you have any questions, call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411.  

If members have questions, refer them to their county or the Health Care Consumer Support line at 651-431-3722 or 833-970-0047. (pub. 7/15/25)

Effective immediately, MHCP now requires doula providers to submit their MDH certification letter that shows active registration dates with their enrollment or revalidation application. We now require this because MDH no longer lists start and end dates along with the individual name in their online doula registry so we are unable to verify dates through the registry. 

Doula providers should note the following:

• MHCP will return all enrollment requests (new or previously submitted) if they do not include the MDH certification letter; and we will ask that you resubmit the request with the certification letter. Allow 30 days from the date of the submission for processing. 
• You can submit the certification letter by uploading to the credentials page in the Minnesota Provider Screening and Enrollment portal.
• Currently enrolled doula providers do not need to submit the MDH certification letter. 

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 7/7/25)

Due to new legislative updates and revalidations, the MHCP Provider Resource Center is experiencing high call volume. You may experience a longer wait time or you will have to call back at a different time. 

You may also refer to the following webpages:

• MHCP billing resources webpage for billing resources 
• MHCP provider training webpage for free training sessions for specific provider types and services

We will offer free question and answer sessions for the MPSE Portal beginning Feb. 7, 2024. Refer to the Minnesota Provider Screening and Enrollment (MPSE) portal training webpage for more information about the sessions. (pub. 1/29/24)

The Minnesota Department of Human Services will be offering weekly questions and answers sessions for the MPSE Portal. Questions and answers sessions take place every Wednesday from 1 to 2 p.m. starting on Feb. 7, 2024. These sessions are free and no registration is required.

MPSE questions and answers sessions will be held virtually using the Microsoft Teams platform, but attendees do not need to have Microsoft Teams installed. Participants can use the browser version. Find the link to join the questions and answers session on the MPSE portal training webpage.

Who should attend?

• Owners of MHCP-enrolled organizations.
• Individual providers who maintain their own MHCP enrollment records.
• Employees of MHCP-enrolled organizations who maintain provider enrollment records. 
• Employees of MHCP-enrolled organizations who process affiliations or do credentialing.
• Employees of MHCP-enrolled organizations responsible for MHCP compliance. 
• Individuals or organizations interested in becoming an MHCP provider for the first time.
• Anyone interested in learning more about the MPSE portal.

(pub. 3/18/24)

MHCP offers training for providers who provide services for members enrolled in MHCP. We have updated on-demand and online training opportunities on the MHCP provider training webpage.

On-demand videos
On-demand videos are arranged by category, including Minnesota Provider Screening and Enrollment Portal (MPSE), MN–ITS and Billing. Each video can be viewed in 10 minutes or less and provides instructions on a concept or technique.

Online training
Online training is arranged by content for all providers or specific providers. Training is led by an instructor who will help attendees navigate the Minnesota Department of Human Services website and locate and use MHCP provider information and other related webpages or internet-based applications such as MN–ITS. All instructor-led training is online only. (pub. 11/22/22)

Minnesota Health Care Programs (MHCP) offers free online training for MHCP-enrolled providers. Go to the MHCP provider training webpage to review the list of available training. (rev. 3/3/25)

Minnesota Health Care Programs (MHCP) is offering free online Provider Basics Resources and MN–ITS training to all enrolled MHCP providers who bill fee-for-services claims. This training is being offered monthly beginning Mar. 10, 2021.

You will learn how to navigate the MHCP provider webpages and the MHCP provider manual, and how to use MN–ITS administration, mailbox and eligibility requests (270/271) features. Go to the Provider Basics webpage to register for this training.

Claim training is not provided in this training. Refer to the MHCP provider training webpage to register for provider-specific claim training. (pub. 2/11/21)

Minnesota Health Care Programs (MHCP) offers free on-demand training videos arranged by category on the MHCP provider training webpage. Each video can be viewed in about 10 minutes and provides instructions on a concept or technique. (pub. 6/3/25)