The current Medical Assistance rates for mental health services fee-for-service (FFS) rates for mental health services are included in the below table and are updated to reflect the most current maximum allowed, FFS rate for the code. The table also explains when services are reimbursed at an adjusted rate in certain circumstances.
The goal of Adult Day Treatment (ADT) is to reduce or relieve the effects of symptoms associated with a diagnosed mental illness and provide skills training that will result in the person to live in their community. ADT is a short-term, community-based mental health program services consisting of group psychotherapy, rehabilitative interventions, and other therapeutic group services provided by a multidisciplinary team.
Adult Rehabilitative Mental Health Services (ARMHS) are a set of services that were developed to bring restorative, recovery-oriented interventions directly to individuals who have the capacity to benefit from them, whether in their homes or elsewhere in the community. ARMHS includes four components: basic living and social skills, community intervention, medication education, and transitioning to community living.
Assertive Community Treatment (ACT) is an intensive, comprehensive, non-residential rehabilitative mental health service that uses a team approach. Services are consistent with Adult Rehabilitative Mental Health Services, except that ACT services are (a) provided by multidisciplinary, qualified staff who have the capacity to provide most mental health services necessary to meet the person’s needs, using a total team approach; (b) directed to persons with a serious mental illness who require intensive services; and (c) offered on a time-unlimited basis and available 24 hours per day, 7 days per week, 365 days per year.
Certified Community Behavioral Health Clinics (CCBHC) are community clinics that offer mental health and substance use disorder services as well as a range of other services. CCBHC will provide outreach, increase access, improve services, and serve as a “one-stop-shop” within a defined service area.
Certified peer specialists are individuals who have a lived experience of mental illness and are trained to be direct service mental health staff. Since 2007, Minnesota has been building capacity for this service.
Dialectical Behavior Therapy (DBT) is evidence based comprehensive treatment delivered via three modalities; individual therapy, group skills training, and telephone coaching by a team of DBT-trained providers. Team members meet 90 minutes per week as part of a DBT-specific consultation team. DBT treatment is based in cognitive, behavioral and dialectic principles and incorporates both clinical and rehabilitative interventions.
When a person experiences first episode psychosis, it is important someone receive the right care as soon as possible. Psychosis can be treated, and early treatment increases the chance of a successful recovery.
Illness Management and Recovery (IMR) is an evidence-based psychiatric rehabilitation practice. IMR is a step-by- step approach that assists people to set meaningful goals for themselves, make informed decisions about their treatment, acquire information and skills to develop greater mastery over the symptoms of their psychiatric illness, and make progress toward their own personal recovery.
Individual Placement & Support Services (IPS) Supported Employment (SE) is an evidence-based practice that promotes the recovery of people who have serious mental illness through work. This integrated service approach is well defined by eight practice principles and a 25-item fidelity scale. IPS SE is recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Integrated Treatment for Co-Occurring Disorders (IT-COD) is considered an evidence-based practice because research shows in contrast to the “system as usual” approach, individuals with co-occurring disorders experience improved treatment outcomes when they receive this holistic, specialized form of treatment. In this model, the contributions of professionals from both the mental health and substance use fields are merged into a single treatment regimen and setting.
Intensive Residential Treatment Services (IRTS) are time-limited mental health services provided in a residential setting. Recipients of IRTS are in need of more restrictive settings (versus community settings) and at risk of significant functional deterioration if they do not receive these services. IRTS are designed to develop and enhance: psychiatric stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more independent setting.
Adult Mental Health Crisis Response Services assist a person who is experiencing a mental health crisis to cope with that crisis and stay in their own home and community. A mental health crisis responder assesses the crisis, assists the recipient in coping with the crisis, and follows up with the person to assure that he or she receives longer term support and services, if needed, in order to remain at home.
Mental Health Information System (MHIS) is a system used to report the demographic, clinical, and outcomes of clients who received publicly funded ACT, ARMHS, CRISIS, DBT, HWS, ICRS, IRTS, and DCT mental health services. MHIS is a secure web-based reporting system that uses MN-ITS security system for web-access. All enrolled MHCP providers and billing agencies have secure access to MN-ITS. Get technical assistance.
The Mental Health Innovation Grant Program is a new grant program intended to improve access to and the quality of community-based, outpatient mental health services and reduce the number of people admitted to regional treatment centers and community behavioral health hospitals
Minnesota statute defines Adult Mental Health Targeted Case Management services (AMH-TCM) as activities that are designed to help adults with serious and persistent mental illness in gaining access to needed medical, social, educational, vocational, and other necessary services as they relate to the client’s mental health needs. Case management services include developing a functional assessment, and individual community support plan, referring and assisting the person to obtain needed mental health and other services, ensuring coordination of services, and monitoring the delivery of services.
Findings from a number of recent national studies indicate that adults with a serious and persistent mental illness are dying, on average, 25 years earlier than the general public. The leading causes of these premature deaths are heart disease, lung disease, diabetes and cancer. One of the basic reasons for premature death among persons with bipolar disorder or schizophrenia is that very few routinely see their primary care physicians for annual physical health screenings. Yet with regular screening, these diseases can often be prevented by lifestyle changes or can be detected early so treatment can control these health conditions. The goal of the initiative was to increase the average lifespan of Minnesotans with Bipolar Disorder or Schizophrenia by 10 years within 10 years. We refer to this initiative as the Minnesota 10 by 10.
Congress developed the Pre-admission Screening and Resident Review (PASRR) program to ensure that admission and retention of people with serious mental illness in nursing and boarding care facilities is appropriate, as part of the Omnibus Budget Reconciliation Act (OBRA) 1987 commonly referred to as OBRA regulations. Federal Medicaid law and regulations require states
to have a PASRR program to determine whether nursing facility applicants and residents meet nursing facility level of care and/or require specialized services for mental health care.
The MHIS Reporting Manual is a reference guide for mental health providers who are required to report client-level outcome measures in Minnesota. It includes reporting requirements, client data elements and batch requirements. Each provider is responsible to reference and implement the manual information.
Follow the authorization process described in the ARMHS section of the MHCP Provider Manual.
The Minnesota Comprehensive Adult Mental Health Act establishes basic standards for adult mental health services in Minnesota. It is primarily directed at counties, which are designated as local mental health authorities. Click here to see the mission statement.
Rule 29 establishes standards for community mental health centers and clinics in Minnesota. Compliance with this rule is required for certain categories of Medical Assistance payments and for certain types of private insurance reimbursement. Each section of the rule is listed below and can be accessed by clicking on the rule number.
Rule 36 establishes standards for adult mental health residential facilities in Minnesota. Compliance with this rule is required for facilities that provide residential mental health treatment for more than four adults. Each section of the rule is listed below and can be accessed by clicking on the rule number.
Intensive Residential Rehabilitative Mental Health Services (IRTS) (PDF) The primary purpose of this standard variance is to describe the licensing requirements that providers seeking Medical Assistance (MA) reimbursement must adhere to in the provision of Intensive Residential Rehabilitative Mental Health Services and Residential Crisis Stabilization Service. These requirements reflect the merging of current Rule 36 (Minnesota Rules 9520.0500 to 9520.0690) and the legislation which allowed for Intensive Residential Rehabilitative Mental Health Services and Residential Crisis Stabilization Services (M.S. 256B.0622 and 256B.0624 respectively). Please note that additional regulatory and procedural requirements may apply (e.g. provider enrollment, recipient eligibility, billing, etc.) and are contained in the Medical Assistance Provider Manual.
Rule 47 is the state rule that governs Minnesota health care programs reimbursement for outpatient mental health services. Each section of the rule is listed below and can be accessed by clicking on the rule number.
Rule 79 establishes standards for mental health case management in Minnesota. These standards apply to case managers who are employed by the county or under contract with a county. Each section of the rule is listed below and can be accessed by clicking on the rule number.