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. Sign up to receive provider news and other MHCP notices through our free provider email lists.
Systems announcements
Update on DHS connections with Change Healthcare
Minnesota Department of Human Services (DHS) is aware of how recent cyberattacks are impacting our providers and their clearinghouses and VANs. Minnesota Health Care Programs claims processing and pharmacy point-of-sale systems are functioning normally. DHS is working with Optum on a security assessment of their Change Healthcare platform and may restore connections based on the results of that assessment. (pub. 5/8/24)
Minnesota Health Care Programs (MHCP) is aware that some mental health treatment supervisory services claims submitted by mental health professionals and certified rehabilitation specialists are incorrectly denying. Effective Oct. 17, 2022, mental health professionals and certified rehabilitation specialists have been qualified to provide supervisory services based on their licensure.
We are working to fix the issue and will reprocess claims that were incorrectly denied. Providers can continue submitting claims.
Additionally, MHCP discontinued Qualified Mental Health Professional Clinical Supervision Assurance Statement (DHS-6330) because mental health professionals and certified rehabilitation specialists no longer need to complete the form.
We will post a future Provider News message on this webpage when claims are reprocessed. (pub. 5/16/24)
The Minnesota Department of Human Services (DHS) is aware that the three percent rate increase approved for certain fee-for-service mental health services is causing some claims to be incorrectly reimbursed for the following providers.
Indian health services, federally qualified health centers and rural health clinics providers: These providers should not receive the three percent increase because they are reimbursed an encounter rate.
Mental health services providers: Reimbursement rates for some fee-for-service mental health services increased by three percent effective Jan. 1, 2024, but should not have been included in the increase.
DHS implemented the three percent rate increase on the April 9, 2024, warrant and this resulted in some claims to be incorrectly reimbursed. We will review claims from previous warrants and correct any payment errors.
We will post a future Provider News message on this webpage when the system change is corrected and claims are reimbursed at the correct rate. (pub. 5/16/24)
The Minnesota Department of Human Services (DHS) requests public comments on the Community First Services and Supports (CFSS) Policy Manual. The deadline to submit comments is Friday, June 14, 2024, no later than 4 p.m.
Registration is now open for the personal care assistance (PCA)/community first services and support (CFSS) Steps for Success workshop scheduled for June 26-28, 2024. Registration will close three business days before the workshop at 8 a.m.
Steps for Success is a three-day workshop offered to PCA/CFSS agency owners and managing or supervising staff to meet the PCA/CFSS agency provider training requirements for enrolling or maintaining enrollment with Minnesota Health Care Programs (MHCP).
To register for this training, click on the Registration and cost link on the PCA/CFSS Steps for Success workshop webpage. The workshop is online only.
Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with any questions. (pub. 5/15/24)
Effective June 1, 2024, Health Care Consumer Support (HCCS) will no longer accept any materials submitted by fax from Hospital Presumptive Eligibility (HPE) providers.
Providers must now submit using the HCCS Document Portal for Partners and Providers. Using the portal eliminates fax transmission errors, ensures accurate submission of documents, and creates efficiency in the processing for HPE clients, partners, providers and HCCS. We encourage using the HCCS Document Portal before HCCS removes the fax line on June 1, 2024.
You do not need to register or create a user ID or password to use the HCCS Document Portal. View a video demonstration of the HCCS document portal or refer to the HPE program webpage for user instructions and other information.
Contact HCCS for HPE at 651-431-3480 or 888-702-9968 (option 1) with any questions. (pub. 5/10/24)
Effective June 1, 2024, Health Care Consumer Support (HCCS) will no longer accept any documents submitted by fax from Minnesota Family Planning (MFPP) providers.
MFPP providers must now submit documents using the HCCS Document Portal for Partners and Providers. Using the portal eliminates fax transmission errors, ensures accurate submission of documents, and creates efficiency in the processing for MFPP clients, partners, providers and HCCS. We encourage using the HCCS Document Portal before HCCS removes the fax line on June 1, 2024.
You do not need to register or create a user ID or password to use the HCCS Document Portal. Refer to the MFPP forms, documents and resources webpage for user instructions and other information.
Contact HCCS for MFPP at 651-431-3480 or 888-702-9968 (option 3) with any questions. (pub. 5/9/24)
The Minnesota Department of Human Services (DHS) plans to implement CFSS on October 1, 2024.
For more information, refer to the Aging and Adult Services and Disability Services Division eList announcement: DHS announces CFSS implementation timeline. (pub. 5/8/24)
Minnesota Health Care Programs recently discovered that the claims system is not identifying and denying claims for members receiving a second monthly ventilator rental without an approved authorization. We will not reprocess past claims that paid in error. You must submit authorization requests for secondary ventilator rentals to the medical review agent. Claims will deny when there is not an authorization beginning July 1, 2024.
Refer to the Respiratory Equipment section of the MHCP Provider Manual for information on ventilators. Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 5/8/24)
Minnesota Health Care Programs (MHCP) is currently experiencing a system issue which may cause claims with the KU modifier to pay incorrectly. Currently, Medicare crossover claims are pulling the incorrect rate file. We are reviewing programming to ensure that any system update will process claims by applying the appropriate rate. We will post a message on this webpage when the issue is resolved. (pub. 5/8/24)
You must submit the report if you performed any of the following during the 2022-23 school year:
Processed service billing, received payments, and reported all necessary cost data using the Special Education Data Reporting Application (SEDRA) administered by the Minnesota Department of Education (MDE).
Documented and forwarded a detailed count of Medical Assistance (MA) service hours and interactions to DHS using the Individualized Education Program (IEP) Services Annual Data Report Form (DHS-5052)for the following services:
Physical therapy
Occupational therapy
Speech-language pathology and audiology
Mental health services
Nursing services
Personal care assistance services
Interpreter services
Provided DHS with a comprehensive report detailing the total number of special transportation trips and the count of MA-eligible children who utilized special transportation services during the 2022-23 school year through the submission of the Individualized Education Program (IEP) Services Annual Data Report Form (DHS-5052).
Failure to submit the required cost data for the provided IEP services, along with received payments, by July 5, 2024, will result in the final rate for the respective service being assessed at $0.00.
Email dhs_rates_iep@state.mn.us with questions about the required documentation. Email the Special Education Funding and Data Team of MDE at mde.spedfunding@state.mn.us with questions about SEDRA. (pub. 5/7/24)
We revised this message to clarify when asset limits resume. Some MA enrollees will again be subject to asset limits to determine their eligibility for health insurance beginning with renewals processed for July 1 coverage. If you serve aged, blind or disabled individuals you should be aware because this may impact people receiving your services. Please pass this information on to your patients. Visit the Income and asset limits webpage for more information about enrollees and asset limits. (pub. 4/23/24, revised 5/6/24)
The Minnesota Department of Human Services (DHS) is changing the requirement to complete the PCA Agency Resources and MN–ITS Training. The designated billing person must complete the training within 30 days of the date of active enrollment and within 30 days of changes to the designated billing person, effective May 6, 2024.
Hospital staff will learn about effective care for youth experiencing a behavioral health crisis in new, free, webinar-based trainings. Trainings will teach you how to address youth behavioral health and manage challenging behaviors.
The Minnesota Department of Human Services partnered with the Training Institute at People Incorporated to provide live trainings throughout 2024 and 2025 and offer recorded versions for later viewing. Upcoming trainings include the following:
Cultural and Equity Considerations – May 16, 10 – 11:30 a.m.
Providers will gain skills and strategies to navigate cultural conversations and tips for learning about the child’s perspective. Go to the Cultural and Equity Considerations webpage to review the course description and register.
Patient Engagement – May 20, 2 – 2:30 p.m.
Learn a guiding style of communication to explore what is important for youth, especially those that may be apprehensive of care options. Go to the Patient Engagement webpage to review the course description and register.
School-based mental health and substance use disorder professionals will explore topics related to effective care for youth experiencing a behavioral health crisis in this new, webinar-based training series. The Minnesota Department of Human Services will be partnering with the Training Institute at People Incorporated to provide trainings that address youth behavioral health and managing challenging behaviors.
Trainings will run throughout 2024 and 2025 and will be offered live, as well as recorded for later viewing. Upcoming trainings include the following:
Building Resiliency and Self-Care – May 14, 3:30 – 5 p.m.
Explore the problem of chronic unremitting stress on our overactive and distracted brains and learn a set of different skill sets for robust mental health that can be learned and practiced by anyone. Go to the Building Resiliency and Self-Care webpage to review the course description and register.
Cultural and Equity Considerations – May 22, 3:30 – 5 p.m.
Uncovers how children’s cultural identities and experiences shape the way they make meaning of the world and relate to others. This training looks at practical strategies for learning about the child’s perspective and tips for conducting such conversations. Go to the Cultural and Equity Considerations webpage to review the course description and register.
This is a reminder that the SASD support team will no longer have an active fax number beginning May 1, 2024. Several provider groups will now have to use online forms to submit materials that previously were faxed to the SASD support team. Refer to the following guidance.
Personal care assistance (PCA) – Use the following online form to request a technical change:
County public health agencies, tribal nations and PCA assessors contracted by a lead agency – Use the following online form to request a technical change:
When submitting forms, double-check that you have correctly entered your name and contact information, such as email address and phone number. This ensures you receive an auto-generated response that the form was successfully submitted and that the SASD support team can contact you about your request.
Only submit forms to the location and fax number as listed on the form or within the form instructions since the SASD support team fax number will be discontinued.
Minnesota Health Care Programs (MHCP) has created a frequently asked questions resource about the Recuperative Care program as a follow-up to the general information webinar held on Feb. 15, 2024. We recommend reviewing Recuperative Care Program Frequently Asked Questions (PDF) if you are considering enrolling with MHCP as a recuperative care provider in the future. Note, we are temporarily holding on processing enrollment for recuperative care providers at this time. Refer to Revised: Recuperative care provider enrollment temporarily for more information. (pub. 4/26/24)
NEMT services providers cannot bill MHCP for Mode 3 – Unassisted transport (curb-to-curb) and Mode 4 – Assisted transport (door-to-door and door-through-door) services; and must contract with one of the following organizations for billing and reimbursement.
Medical Transportation Management – Minnesota Nonemergency Transportation (MTM-MNET)
SmartLink
Local county or tribal agency
MTM-MNET, SmartLink or the local county or tribal agency bills MHCP for Modes 3 and 4 services and reimburses the NEMT services provider. Refer to Overview under Local County or Tribal Agency NEMT Services in the MHCP Provider Manual for contact information. (pub. 4/24/24)
Minnesota Health Care Programs (MHCP) extended the deadline to receive updated testing results for incontinence products. We must receive new testing results by June 1, 2024, for products to be added to the MHCP Incontinence Products List by HCPCS or Manufacturer.
We will amend the Incontinence Products List on or before May 1 to update products that have received new testing results. We will revise the list again in mid-May and on June 1. For products that are currently on the Incontinence Products List and do not have new test results before May 1, the date column will show as “Pending” during the month of May while testing is being completed. We will remove “Pending” products from the list if we do not receive testing results by June 1.
Refer to MHCP Requirements for Incontinence Products (DHS-3811) to review testing requirements. Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have any questions about incontinence product testing. (pub. 4/23/24)
Some RSC-Targeted Case Management claims incorrectly denied with claim status code 483 and remittance remark code N362 due to a system issue. We have fixed the issue and claims are now processing correctly. We reprocessed all RSC claims that incorrectly denied with this error code, and they will appear on the April 26, 2024, remittance advice. 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. 4/19/24)
The deadline for traditional personal care assistance (PCA) workers to apply for a PCA training stipend is June 15, 2024. Traditional PCA workers provide PCA services through a personal care provider organization. Review the Reminder: Apply for the PCA training stipend by June 15, 2024, eList announcement from the Adult and Aging Services Division and Disability Services Division for more information. (pub. 4/9/24)
The Centers for Medicare and Medicaid Services (CMS) has approved rate increases for some behavioral health services provided on or after Jan. 1, 2024.
Behavioral health Adult Day Treatment Services (ADT) rates have increased and are now paid at the base rate of $30.62 per 60 minutes. ADT services are billed using procedure code H2012.
Behavioral Health services rates also increased by 3% for other procedure codes. Review the codes in the following Codes with 3% rate increase table.
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. 4/9/24)
We updated testing for Cardinal Health and Essity products on the 2020-2024 Incontinence Products Lists by Manufacturer and HCPCS. We updated testing for 30 products. The updates are effective April 8, 2024.
Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 4/9/24)
Refer to Moving Expenses on the Housing Stabilization Services policy webpage for more information about Moving Expenses. Email hshousingstabilization@state.mn.us if you have questions about this message. (pub. 4/1/24)
This is a reminder that the screening and enrollment process for all contracted managed care organization (MCO) providers started July 17, 2023. The 21st Century Cures Act requires all Medicaid managed care network providers be screened and enrolled by the Minnesota Department of Human Services (DHS). This includes ordering, referring, and prescribing (ORP) providers furnishing services to managed care members.
Organizational providers must enroll each location that delivers services to MHCP members. All MCO in-network providers who already have an existing contract with an MCO and ORP providers furnishing services must enroll by July 15, 2024, except for the following provider types that will require a site visit from the Minnesota Department of Human Services (DHS):
Community Mental Health Center−Provider type 10
Rehab Agency− Provider type 11
Day Treatment− Provider type 46
Home Care Nursing Organization−Provider type 64-O
Medical Transportation−Provider type 82
MHCP will conduct an announced site visit within 60 days of the referral date (providers will receive a letter from MHCP). The providers in the bulleted list must complete both the enrollment process and site visit by Dec. 31, 2024.
Existing MCO providers who fail to comply with the federal enrollment mandate will be removed from the managed care MHCP provider network and will no longer be eligible to receive payments for MHCP members. To ensure you meet the enrollment deadline, submit your DHS enrollment application as soon as possible. Actively enrolled fee-for-service providers who have an existing contract with an MCO will not need to go through the screening and enrollment process again.
Attend a live demonstration to learn more about the enrollment requirements and how to enroll using the Minnesota provider Screening and Enrollment (MPSE) portal. You must register for the training webinar. The same information will be provided at each session:
The Minnesota Department of Human Services offers quarterly webinar sessions to providers required to use EVV. The webinar sessions cover updates, resources, and Q&A. The sessions are scheduled from 1 to 2 p.m. on the following dates:
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.
Minnesota Health Care Programs (MHCP) is updating our system with the following new current procedural terminology (CPT) codes for reporting monovalent (single strain) COVID-19 vaccines and new single administration code. We will reprocess claims back to Sept. 11, 2023, when the update is completed.
The following new COVID-19 vaccines CPT codes are effective for dates of service on, or after, Sept. 11, 2023.
91304 (SARS-COV-2 VAC 5MCG/0.5ml IM Novavax COVID-19 Vaccine)
91321 (SARSCOV2 VACCINE 25 MCG/0.25 ML Moderna COVID-19 Vaccine)
91322 (SARSCOV2 VACCINE 50 MCG/0.5 ML Moderna COVID-19 Vaccine)
The following new COVID-19 vaccine administration code is effective for dates of service on, or after, Sept. 11, 2023.
90480 immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-COV2) (coronavirus disease [covid-19]) vaccine, single dose
Report the administration code for the administration of vaccine CPT code 91304, 91318, 91319, 91320, 91321 and 91322
We will post a Provider News message on this webpage when claims are reprocessed. Note, we do not guarantee payment after reprocessing if the claim is not submitted following MHCP guidelines.
For eligible MHCP members ages 0-18, MHCP will only reimburse for the administration of the COVID-19 vaccines available through Minnesota Vaccines for Children (MnVFC). Refer to Billing for Child Vaccines for billing instructions.
For eligible MHCP members ages 19 and older, MHCP reimburses for COVID-19 vaccines and vaccine administration. Refer to Billing for Adult and Non MnVFC Vaccines for billing instructions. (pub. 1/25/24)
The Minnesota Health Care Programs (MHCP) dental benefits for 2024 have been implemented and reflect there are no longer age or pregnancy status as qualifiers effective Jan. 1, 2024, because of legislation passed during the 2023 Session (Minnesota Statutes, 256B.0625, subdivision 9).
We are currently experiencing a processing delay which may cause claims to pay incompletely. We will automatically reprocess all dental claims that were paid incompletely when the system update is completed. No action is needed at this time from providers.
We will post a message on this webpage with updated claim and billing information when available. (pub.1/4/24)
We explained on Sept. 27 on this webpage that the temporary waiver allowing personal care assistance (PCA) agencies to hire certain family members to be paid to provide PCA services ended Nov. 11, 2023. This is a reminder this temporary waiver ended Nov. 11, 2023.
The family members that the waiver allowed to be paid for providing PCA services were:
Parents of minors
Stepparents of minors
Legal guardians of minors
Spouses
The Minnesota Department of Human Services (DHS) previously announced an extension of the end date for this waiver in a May 12, 2023, eList.
Effective Nov. 12, 2023, Minnesota Health Care Programs (MHCP) or a person’s managed care organization (MCO) cannot pay PCA agencies for claims with dates of service provided after Nov. 11, 2023, by these family members.
People and families should work together with their PCA agency to develop an alternative plan for providing PCA services. They can contact their lead agency (county, tribal government, or managed care organization) for additional support if they continue to struggle with staffing.
Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 or use the Disability Services Division Contact Form to submit an inquiry with questions. (pub. 9/27/23 and 10/24/23, rev. 12/5/23)
Minnesota Department of Human Services refreshed the Renew My Coverage webpage and will launch new tools in the coming weeks to make it easier for Minnesotans to keep their health insurance now that annual member eligibility renewals have resumed in public health care programs. Please share this information with the members you serve.
Members should look for:
A new envelope design to help renewal paperwork stand out better in mailboxes. Envelopes are now marked with a blue circle with the text “Important information enclosed.”
A new document upload tool that allows members to skip the postage and upload their annual eligibility renewal documents online. Enrollees can also submit renewal paperwork by postal mail, dropping it off at their county or tribal office, fax or by giving their information verbally over the phone.
Members will soon be able to:
Use a new renewal date lookup tool to find out when to watch their mail for renewal information.
Receive text messages from the number “28343” when it’s time to fill out and submit their renewal paperwork.
We are committed to ensuring that eligible Minnesotans retain their public coverage when renewal processes resume as required by Congressional legislation that states to return to standard Medicaid eligibility procedures. On the Renew my coverage webpage, we have created a one-stop shop for Medical Assistance and MinnesotaCare members with all the information they need about how to keep their insurance.
The most important thing enrollees can do now to prepare for their renewal is to Update their contact information. Members who have moved in the last three years should update their address, phone number and email, so they can be reached.
Renewal information will be mailed to members in monthly waves or “cohorts” each month for the next 12 months. The first group of Minnesotans due for their renewal paperwork will get their renewal information mailed within the next few weeks. (pub. 4/27/23)
Minnesota Health Care Programs (MHCP) posted a Provider News message on October 25, 2022, about the category of service edit occurring for the following COVID-19 vaccines and administration codes:
Vaccine 91304
administration codes 0041A and 0042A
Vaccine 91308
administration codes 0081A, 0082A and 0083A
Vaccine 91311
administration codes 0111A, 0112A and 0113A
Vaccine 91307
administration codes 0071A, 0072A, 0073A, and 0074A
The category of service edit is now fixed. We reprocessed claims back to the effective dates for the covered codes included in this message.
Find the effective dates for the covered codes on the MHCP fee schedule webpage or under Vaccines in the Billing section under Coronavirus (COVID-19) in the MHCP Provider Manual. (pub. 1/31/23)
Training
Minnesota Health Care Programs (MHCP) offers free training for MHCP enrolled providers.
Minnesota Health Care Programs (MHCP) will host free online trainings for doula organizations and individual providers wanting to enroll with MHCP. You will learn about the MHCP provider enrollment manual and view a live demonstration of the enrollment process in the Minnesota Provider Screening and Enrollment (MPSE) portal.
Participants need the following to attend the webinar.
Ability to connect to the webinar from their own computers. You do not need special hardware or software. We recommend not using a phone or tablet.
Ability to communicate with presenters using the chat feature available as part of the webinar session.
Internet access.
Speakers or a headset.
Register for the doula provider enrollment MPSE live demonstration on the MPSE portal training webpage.
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.
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.
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. See our 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.
New video:
Verifying MHCP Eligibility in MN–ITS - This video shows a consolidated provider how to determine eligibility for a subscriber (member) receiving care. This video explains how to fill out the 270 screen for one or multiple subscribers (members) and read the results on the 271 screen.
Minnesota Health Care Programs is providing free online training for our MPSE online portal.
Visit the MPSE portal training webpage for registration, brief online tutorials to help prepare you for class and more information. (pub. 2/1/20, rev. 2/19/20, 7/27/22)
