MMIS automation process for Jan. 1, 2026

Lead agency (county and tribal nation) staff must refrain from adding or making changes to all service agreements for waivers and state plan services (including Type B service agreements), and programs from Dec. 5-10, 2025, or until DHS gives lead agencies the “all clear” message. This includes:

  • Alternative Care (AC).
  • Brain Injury (BI).
  • Community Alternative Care (CAC).
  • Community Access for Disability Inclusion (CADI).
  • Developmental Disabilities (DD).
  • Elderly Waiver (EW).
  • Essential Community Supports (ECS).
  • Personal care assistance services (PCA).
  • Community First Services and Supports (CFSS).
  • Consumer Support Grant (CSG).
  • Home care nursing (HCN)
  • Home care agency services.

During this time, DHS will enter rates in both MnCHOICES and Medicaid Management Information System (MMIS) and run the automation process. MnCHOICES will update rates and budgets starting Dec.11; MMIS will start Dec. 5. This is a change from prior years.

Lead agency staff must wait to add or update any service agreements during the MMIS freeze while DHS enters rates and budgets into MMIS until DHS sends the “all clear” eList announcement.

County and tribal nation staff may enter screening documents during this time. Follow the instructions carefully for the changes to the service agreements on Dec. 5-10, 2025.

Amount of increase

The Minnesota Legislature authorized rate and budget increases for home and community-based and state plan services. The following service rate and monthly budget increases are effective Jan. 1, 2026:

  • 6.013% increase to AC and EW case mix budgets.
  • 6.013% increase to EW 24-hour Customized Living and Customized Living case mix budgets. This is on a rolling basis as service plans are renewed throughout the year.
  • 1.67% increase to ECS budget cap.
  • 6.34% increase to home delivered meals for AC, ECS and EW only.
  • 2.7% increase for AC and EW Environmental Accessibility Adaptations (EAA) only.
  • 3.19% increase to home care nursing (HCN) rates.
  • 3.19% home health aide, skilled nursing, occupational therapy, physical therapy, respiratory therapy and speech therapy rates
  • 3.19% increase to Consumer Support Grant (CSG) budgets for people using CSG in place of home care nursing for home care ratings CA, EN, HL and PD only.
  • Varying increases for PCA services, Community First Services and Supports (CFSS) services and Consumer Support Grant (CSG) budgets. PCA and CFSS rates include changes to the wage component value and implementation factor within the PCA/CFSS rate framework tied to PCA/CFSS home care ratings:
    • 0.13% increase to 1:1 PCA/CFSS, supervision and worker training and development budgets.
    • 0.13% increase to CSG budgets for people replacing PCA with CSG.
    • 4.79% increase to PCA/CFSS complex.
  • Consumer Directed Community Supports (CDCS) budgets (non-enhanced budget).
    • 6.013% increase for AC and EW budgets.
    • 0.130% increase for BI, CAC, CADI and DD budgets.
  • PCA/CFSS enhanced rate increase from 7.5% to 12.5%.
  • CFSS and CSG enhanced budget increase 7.5% to 12.5%.

Affected line items

MMIS partially adjusts service agreement lines for AC, BI, CAC, CADI, DD, EW, ESC and CSG services if the line item both:

  • Includes dates on or after Jan. 1, 2026.
  • Has a status of approved, pending or suspended.

Reports

After the DHS sends the all-clear eList, lead agencies should use the following InfoPac reports to identify service agreements to adjust:

  • MW2083A: Procedure Code Rate Increase Report LTC Waivers/AC Program.
  • MW2083B: Procedure Code Rate Increase DD Program.
  • MW2083D: Procedure Code Rate Increase CSG.
  • MW2083H: Procedure Code Rate Change ECS Program.

If county/tribal nation staff need access to the InfoPac reports, contact your lead agency MMIS security liaison. The liaison must request access from DHS.

Automation process for AC, BI, CAC, CADI, DD, ECS and EW select services listed above

Lines that begin before and end after Jan. 1, 2026

MMIS will:

  1. Change the line item end date to Dec. 31, 2025.
  2. Prorate the units of service.
  3. Add reason code 499 to the line that explains that DHS changed the line because of the rate increase. Any existing reason codes will now display after the 499.
  4. Post edit 380 (automatic line adjustment).

MMIS creates a new line for the same procedure code beginning Jan. 1, 2026. On the new line, MMIS will:

  1. Use the same end date as the original line item.
  2. Use the same provider number.
  3. Add the new rate to the Requested and Approved Rate fields when the procedure code uses the statewide maximum rate. For all other procedure codes, the Request and Approved Rate fields or the Total Amount field will be blank.
  4. Add reason code 499 (any other reason codes that were displayed on the original line are moved to this line after the 499).
  5. Suspend the new line.
  6. Change the service agreement (SA) header status to "T" (partially suspended) if it was originally approved.
  7. Post edit 380 (automatic line adjustment) to route the service agreement to the lead agency for further adjustments.

Lead agencies must:

  1. Review the number of units to determine if adjustments are needed. Lead agencies must check to see if the number of units is sufficient based on the person's needs, adding or subtracting units as appropriate.
  2. Add the requested rate for procedure codes that do not use the statewide maximum rate as identified in step 3 above.
  3. Remove existing reason codes that are no longer needed (except the 499).
  4. Approve the new line.
  5. Change the header status to “A” (approved).

Lines that begin on or after Jan. 1, 2026 (with unused units or total amounts)

MMIS will:

  1. Change the line item status to suspend (if previously approved).
  2. Post edit 380 (automatic line adjustment).
  3. Add reason code 499 to the line that explains DHS changed the line because of a rate change (any existing reason codes will now display after the 499).
  4. Add the new rate to the Requested and Approved Rate fields when the procedure code uses the statewide maximum rate. For all other procedure codes, the Requested and Approved Rate fields or the Total Amount field will be blank.

Lead agencies must:

  1. Add the requested rate for procedure codes that do not use the statewide maximum rate as identified in Step 4 above.
  2. Remove existing reason codes that are no longer needed (other than code 499).
  3. Approve the line.
  4. Change the header status to "A" (approved).

Lines that end after Dec. 31, 2025 (with no unpaid units remaining or with no units remaining after MMIS performs the calculation to prorate the units)

MMIS will:

  1. Change the line item end date to Dec. 31, 2025.
  2. Add reason code 499.

Lead agencies must:

  1. Do nothing unless the service continues after Dec. 31, 2025. If the service continues, lead agencies must enter a new line that begins Jan. 1, 2026, with the correct rate and units.
  2. Approve any new lines created by the lead agency.

Exception to MMIS automation process

County and tribal nation must manually adjust the pre-paid health plans (PPHP) home care services (X5609) represent the total cost of the MA state plan services the managed care organization (MCO) is responsible to cover for people on a waiver enrolled with an MCO. However, the new cost of the home care services (home care nursing, if applicable, and home health services) should be added to the X5609 total.

AC and EW budget cap increases

Counties and tribal nations must follow the instructions below to increase the service agreement total cap amount if needed to allow for the increased rate changes.

Counties and tribal nations must:

  1. Enter and approve a new AC or EW screening document using activity type 05 and assessment result 98 or the next scheduled reassessment entered with an activity type date and effective date on or after Jan. 1, 2026 to change the total cap amount on the service agreement when the county/tribal nation enters and edits the service agreement. Those months through Dec. 31, 2025, will use the case mix budget before the increased cap amount. Those remaining months in the service agreement starting Jan. 1, 2026, will use the increased case mix budget.
  2. Enter into the service agreement and edit it with PF9 to change the total cap amount field to the new pro-rated amount.
  3. Ensure the cost of all services does not exceed the prorated total service agreement budget, otherwise edit 672 (total authorized amount is excessive) will post. The county or tribal nation must reduce the units or total amount on one or more line items so that the total authorized amount field is equal to or less than the total cap amount field on the MMIS ASA1 screen.
  4. Press PF3 to save the changes to the service agreement and exit the document.

Consumer directed community supports

CDCS (T2028) non-enhanced budget

For lines that begin before and end on or after Jan. 1, 2026, MMIS will not adjust line items but will identify the lines on InfoPac reports MW2083A or MW2083B.

Counties and tribal nations must:

  1. AC and EW only: Enter and approve a new AC or EW screening document using activity type 05 and assessment result 98 or the next scheduled reassessment entered with an activity type date and effective date on or after Jan. 1, 2026 to change the case mix amount and the CDCS amount. This will then update the total cap amount on the service agreement when the county/tribal nation enters and edits the service agreement. This will allow the county/tribal nation to increase the amount on the CDCS line item. For the months in the service agreement through Dec. 31, 2025, the county/tribal nation will use the CDCS annual maximum that were in place before Jan. 1, 2026. For the remaining months in the service agreement starting Jan. 1, 2026, the county/tribal nation will use the increased CDCS annual maximum that aligns with the case mix budgets.
  2. Calculate the 2025 portion of the budget:
    1. AC and EW: The county/tribal nation multiplies the case mix budget documented on the most recent approved screening document dated prior to Jan. 1, 2026 by the number of months on the service agreement occurring in 2025. Retain this amount for step 4 below.
    2. BI, CAC, CADI, and DD: the county/tribal nation uses the total annual CDCS budget divided by the number of days in the service agreement to determine a daily amount. Calculate the 2025 portion of the budget by multiplying the result by the number of days on the service agreement line item up to and including Dec. 31, 2025. Retain this amount for step 4 below.
  3. Calculate the 2026 portion of the budget by:
    1. AC and EW: The county/tribal multiplies the monthly CDCS budget that aligns with the 2026 case mix budget that is published in Long-Term Services and Supports Service Rate Limits Effective Jan. 1, 2026, DHS-3945-ENG, by the number of months in the service agreement occurring in 2026. Retain this amount for step 4 below.
    2. For BI, CAC, CADI, and DD, multiply the daily amount from step 2 above by 1.0013 and then multiply the result by the number of days in the service agreement occurring in 2026. Retain this amount for step 4 below.
  4. Add both sums from the results of steps 2 and 3 above and update the existing service agreement CDCS (T2028) line item with the new amount. For AC and EW, the final budget amount cannot exceed the annual maximum CDCS service budget amount published in Long-Term Services and Supports Service Rate Limits Effective Jan. 1, 2026, DHS-3945-ENG, without DHS approval. For exceptions to budget amounts see CBSM CDCS budgets.
  5. Complete CDCS Community Support Plan Addendum, DHS-6633A (PDF), and send it to the person and their financial management services (FMS) provider.

CDCS (T2028) enhanced budget (combined budget increase and enhanced budget increase)

For people that have an approved enhanced budget, the county/tribal nation uses the following instructions to apply both the budget increase and the enhance budget increase.

Counties and tribal nations must:

  1. AC and EW only: Enter and approve a new AC or EW screening document using activity type 05 and assessment result 98 or the next scheduled reassessment entered with an activity type date and effective date of Jan. 1, 2026 or later to change the case mix amount and the CDCS amount. This will then update the total cap amount on the service agreement when the county/tribal nation enters and edits the service agreement. This will allow the county/tribal nation to increase amount on the CDCS line item. For the months in the service agreement through Dec. 31, 2025, the county/tribal nation will use the CDCS annual maximum that were in place before Jan. 1, 2026. For the remaining months in the service agreement starting Jan. 1, 2026, the county/tribal nation will use the increased CDCS annual maximum that aligns with the case mix budgets.
  2. Calculate the 2025 portion of the budget:
    • AC and EW: The county/tribal nation multiplies the case mix budget documented on the most recent approved screening document dated prior to Jan. 1, 2026 by the number of months on the service agreement occurring in 2025. Retain this amount for step 4 below.
    • BI, CAC, CADI, and DD: the county/tribal nation uses the total annual CDCS budget divided by the number of days in the service agreement to determine a daily amount. Calculate the 2025 portion of the budget by multiplying the result by the number of days on the service agreement line item up to and including Dec. 31, 2025. Retain this amount for step 4 below.
  3. Calculate the 2026 portion of the budget by:
    1. AC and EW: The county/tribal nation multiplies the monthly CDCS budget that aligns with the case mix budget that is published in Long-Term Services and Supports Service Rate Limits Effective Jan. 1, 2026, DHS-3945-ENG, by 1.11066 (this includes the budget increase and the enhanced budget) and then multiplies the result by the remaining number of months of the service agreement. Retain this number for step 4 below.
    2. BI, CAC, CADI, and DD: The county/tribal nation multiplies the daily budget by 1.04787 (this includes the budget increase and enhanced budget) and then multiplies the result by the remaining number of days of the service agreement. Retain this number for step 4 below.
  4. Add both sums from the results of steps 2 and 3 above and update the existing service agreement CDCS (T2028) line item with the new amount. For AC and EW, the final budget amount cannot exceed the annual maximum CDCS service budget amount published in Long-Term Services and Supports Service Rate Limits Effective Jan. 1, 2026, DHS-3945-ENG, without DHS approval. For exceptions to budget amounts see CBSM CDCS budgets.
  5. Complete CDCS Community Support Plan Addendum, DHS-6633A (PDF), and send it to the person and their financial management (FMS) provider.

Community First Services and Supports (CFSS) budget model

CFSS budget model on a waiver/AC – T1019 UB (with additional modifiers, if applicable)

For lines that begin before and end on or after Jan. 1, 2026, MMIS will not adjust line items but will identify the lines on InfoPac reports MW2083A or MW2083B.

Person is using their entire CFSS eligibility

The county/tribal nation must:

  1. Calculate the increase using one of the following two methods:
    1. Use the CFSS budget model calculator to find the new amount to enter into the personal care (T1019) line using the number of daily minutes the person is eligible for. (note: DHS will update the calculator with the 2026 COLA after sending the MMIS all-clear message).
    2. Use the directions below under the heading “Person not using their entire CFSS eligibility”
  2. Update the existing T1019 UB (with additional modifiers, if applicable) service agreement line item with the result. For AC and EW, the final budget amount cannot exceed the annual AC/EW budget limits by case mix published in Long-Term Services and Supports Service Rate Limits Effective Jan. 1, 2026, DHS-3945-ENG, without DHS approval. For exceptions to budget amounts see PCA, CFSS and CSG enhanced rate/budget – Supplemental instructions: budget exception process for AC and EW.
  3. Case managers must notify people of their budget increase.

⁠Person not using their entire CFSS eligibility

The county/tribal nation must:

  1. Determine the current budget by adding the amounts in the REQ TOT AMT field of the following fields:
    • Personal care (T1019 UB).
    • Goods and services (T5999 UB).
    • PERS installation (S5160 UB).
    • PERS monthly fee (S5161 UB).
    • PERS equipment (S5162 UB).
    • FMS fee (T2040 UB UA).
    • Failed background study (T2040 UB UA U6).
    • Note: the county/tribal nation does not include the extended personal care (T1019 UB UC) line.
  2. Determine the daily budget amount by dividing the result of step 1 by the number of days in the service agreement.
  3. Determine the 2025 portion of the budget by multiplying the result of step 2 by the number of days in 2025.
  4. Determine the 2026 portion of the budget by:
    1. Multiplying the result of step 2 by the number of days in 2026.
    2. Multiplying the result of step 4a by the 1.0013 (people not eligible for the enhanced rate) or 1.0479 (people eligible for the enhanced rate).
  5. Determine the new budget by adding the results of step 3 and 4b.
  6. Subtract the result of step 1 from the result of step 5.
  7. Add the result of step 6 to the current amount listed in the REQ TOT AMT field of the personal care line (T1019).
  8. Enter the result of step 7 into the REQ TOT AMT field of the personal care (T1019 UB) line.
  9. Inform the person of their new budget amount.

Extended CFSS

The county/tribal nation must:

  1. Determine the daily extended budget amount by dividing the current entry in the extended personal care (T1019 UB UC) line by the number of days in the service agreement.
  2. Determine the 2025 portion of the budget by multiplying the result of step 1 by the number of days in 2025.
  3. Determine the 2026 portion of the budget by:
    1. Multiplying the result of step 2 by the number of days in 2026.
    2. Multiplying the result of step 3a by the 1.0013 (people not eligible for the enhanced rate) or 1.0479 (people eligible for the enhanced rate).
  4. Add the results of steps 2 and 3.
  5. Enter the result of step 4 in the TOT REQ AMT field of the extended personal care (T1019 UB UC) line.
  6. Inform the person of their new budget amount.

CFSS budget model on Type B agreements

MMIS will automatically adjust the SA if the service agreement meets all of the below requirements:

  • Is a type B service agreement
  • Has a header end date later than 12/31/2025
  • Has a header status of A (approved) or T (partially suspended).
  • Includes approved line items for CFSS Budget Model (T1019 UB) with a requested amount greater than zero and does not include modifiers U4, U5, or U6
  • Does not include approved lines for procedure codes for T1002 or T1003 (regardless of modifiers)

If the service agreement does not meet these requirements the document will be reported out to internal DHS staff to manually adjust the document.

MMIS automatically prorates the increase and adds it to the CFSS budget line (T1019 UB (or with additional modifiers, if applicable) by:

  1. Determine the rate-increase-difference:
    1. Non-complex (no TG modifier): The regular rate increases from $6.21 to $6.22 (an increase/difference of $0.01) as of Jan. 1, 2026.
    2. Complex rate (TG modifier): The complex rate increases from $6.67 to $6.99 (an increase/difference of $0.32) as of Jan. 1, 2026.
  2. Determine number of days on the T1019 UB (or with additional modifiers, if applicable) line that are affected by the increase (i.e. number of days on or after Jan. 1, 2026.
  3. Determine the average units per day based on accepted Type-B T1019 Budget logic:
    1. If the entry in the HOME CARE RATING field is EN (i.e. vent dependent): MMIS uses 112 for the average units per day.
    2. If the entry in the HOME CARE RATING is not EN: MMIS uses the value in the TOTAL TIME field divided by 15 to get the average units per day.
  4. Multiplies the results of steps 1, 2 and 3
  5. Adds the result of step 4 to the T1019 UB (or with additional modifiers, if applicable) line’s original AMOUNT REQUESTED field and the SA’s header TOT AUTH AMT on the SA ASA1 screen.
  6. Adds reason code 499 to the T1019 UB (or with additional modifiers, if applicable) line that explains the line was changed because of a rate change (any existing reason codes will now display after the 499).

After making the adjustment, MMIS triggers a service agreement letter issued to person receiving services or their representative and to the provider listed on the affected SA line item.

PCA, CFSS agency model and home care services on Type B agreements

Counties and tribal nations are not responsible to modify PCA, CFSS agency model, home care nursing or home health agency services on Type B agreements. These are not run through the MMIS automation process. The MMIS rate file is adjusted and updated automatically during the billing process.

PCA, CFSS agency model and home care services on waiver and AC agreements

Counties and tribal nations must adjust the rates for all PCA, CFSS and home care services that are authorized on a waiver and AC service agreements.

Lines that begin on or after Jan. 1, 2026, with unused units (other than worker training and development)

MMIS will:

  1. Change the line item status to suspended (if previously approved).
  2. Post edit 380 (automatic line adjustment).
  3. Add reason code 499 to the line that explains the line was changed because of a rate change (any existing reason codes will now display after the 499).
  4. Add the new rate to the Requested and Approved Rate fields when the procedure code uses the statewide maximum rate. For all other procedure codes, the Requested and Approved Rate fields or the Total Amount field will be blank.

Counties and tribal nations must:

  1. Add the requested rate for procedure codes that do not use the statewide maximum rate as identified in Step 4 above.
  2. Remove existing reason codes that are no longer needed (other than code 499).
  3. Approve the line.
  4. Change the header status to "A" (approved).

CFSS worker training and development (S5116) lines for both models

CFSS worker training and development (S5116) lines for type B

MMIS does not update worker training and development (WTD) S5116 with all modifiers on Type B service agreements. Provider agencies must follow the standard process to request additional funds. For more information, see CFSS manual – CFSS worker training and supervision.

CFSS worker training and development (S5116) lines on waiver and AC agreements

  • MMIS will split the line items during the automation process.
  • Service line identified on InfoPac reports MW2083A and MW2083B. Follow the automation steps above.

CSG service agreements

Counties and tribal nations must follow the Consumer Support Grant (CSG) manual adjustment of service agreement line instructions below.

CSG service agreements for both PCA and HCN home care ratings are part of the MMIS automation process that runs on Dec. 10, 2025.

For lines that begin before and end after Jan. 1, 2026

MMIS will:

  1. Change the line item end date to Dec. 31, 2025.
  2. Add reason code 499 to the line that explains that the line has been changed because of the rate increase. Any existing reason codes will now display after the 499.
  3. Post edit 380 (automatic line adjustment) and add the service agreement to report MW2083D issued to the lead agency for further adjustments.

MMIS creates a new line for the same procedure codes beginning Jan. 1, 2026. On the new lines, MMIS will:

  1. Use the same end date as the original line items.
  2. Use the same provider numbers.
  3. Leave the requested total amount fields blank.
  4. Add reason code 499 (any other reason codes that were displayed on the original line are moved to this line after the 499).
  5. Suspend the new lines.
  6. Change the service agreement header status to "T" (partially suspended) if it was originally approved.
  7. Post edit 380 (automatic line adjustment) and add the service agreement to report MW2083D issued to the lead agency for further adjustments.

Counties and tribal nations must:

  1. Reduce the requested total amount fields on the line items that end Dec. 31, 2025.
  2. Determine the new CSG monthly budget effective Jan. 1, 2026.
  3. Review new lines, one authorized to the FMS (95%) and one for the county administrative costs (5%), beginning Jan. 1, 2026, and extending to the end of the service agreement.
  4. Enter the new total amount on the lines beginning Jan. 1, 2026, based on the 2025 CSG monthly budget limit times the number of months of the line.
  5. Press PF9 to edit the service agreement. MMIS will redetermine the CSG cap amount on the ASA1 screen and post edits as appropriate.
  6. Resolve all county-based edits.
  7. Approve the new lines.
  8. Verify the header status is "A" (approved).

Lines beginning on or after Jan. 1, 2026

MMIS will:

  1. Change the line item status to suspend (if previously approved).
  2. Add reason code 499 to the line that explains the line was changed because of a rate change (any existing reason codes will now display after the 499).
  3. Leave the requested total amount field as-is.
  4. Post edit 380 (automatic line adjustment) and add the service agreement to report MW2083D issued to the lead agency for further adjustments.

Counties and tribal nations must:

  1. Determine the new CSG monthly budget effective Jan. 1, 2026.
  2. Add the total amount on the two CSG lines, one authorized to the FMS provider (95%) and one for the county administrative costs (5%) using the 2026 CSG monthly budget limit times the number of months on the line.
  3. Press PF9 to edit the service agreement. MMIS will re-determine the CSG cap amount on the ASA1 screen and post edits as appropriate.
  4. Resolve all county-based edits.
  5. Verify the header status is "A" (approved).