MHCP provider news and updates

MN–ITS will be moving to LoginMN soon. Log in to MN–ITS and validate your email and phone number. If you do not log in to MN–ITS to validate your email and phone number, your login information will not transfer to LoginMN and you will not be able to access MN–ITS. 

Before the move, you will receive a pop-up message in MN–ITS to enter and confirm your work email and phone number. You will only need to complete this once for each username you have for MN–ITS. The email address you use will be your username when we move to LoginMN. 

You must use an email address unique to a single user. Do not use a general business email address. For example: Use jane.biller@businessname.com, not info@businessname.com. You should use your same work email and phone number if you currently have multiple MN–ITS account logins. For example: You are a biller for five different providers (NPIs 1234567890, 2345678901, 3456789012, 4567890123, 5678901234), you should use the same email address for all five. Use an email address specific to you, such as jane.biller@businessname.com. (pub. 2/6/26)

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.

For continuity of care, providers in one of the 13 high-risk services who have submitted an appeal by Tuesday, June 9, 2026, will have their payment suspension lifted by end of day Thursday, June 11, 2026. A memo confirming your payment suspension lift will be sent via MN–ITS mailbox (PRVLTR file type).

Please note: You must submit an appeal for each enrolled location or provider record if you own or operate multiple agencies or locations.

Additionally, DHS is allowing providers an additional 24 hours to submit their claims for this warrant cycle - extending the claims submission cut off to 11:59 p.m. on Friday, June 12, 2026. (pub. 6/10/26)

The Minnesota Department of Human Services finished a comprehensive top-to-bottom review of nearly 5,600 high-risk Medicaid providers on time on May 31. Completing the effort is a key part of Minnesota’s plan to stop the federal government from withholding up to $2 billion from its Medicaid program. 

The five-month review required providers to show they met heightened legal and eligibility standards required to operate and serve vulnerable people.

“More than 1 million Minnesotans deserve to have confidence and trust in the Medicaid providers they depend on for lifesaving and life-affirming care,” said Deputy Commissioner Shireen Gandhi. “We are grateful to the providers who successfully completed the revalidation process and will continue to provide quality care.” 

The Minnesota Department of Human Services issued a press release June 4 which included information about:

• The revalidation process, including provider enrollment and disenrollment numbers
• Continued access to Medicaid services for Minnesotans
• Efforts to rebuild trust in Minnesota’s Medicaid

Refer to Minnesota completes review of nearly 5,600 high-risk Medicaid providers to protect $2B in federal funding to read the press release. (pub. 6/5/26)

View all fighting fraud, waste and abuse messages.

The Minnesota Department of Human Services is participating in a Centers for Medicare & Medicaid Services (CMS) Managed Care Plan Project audit for Early Intensive Developmental and Behavioral Intervention (EIDBI) providers and peer recovery services providers.

Authorized vendor identification
CoventBridge Group is the contracted vendor authorized to request and review medical and administrative records on behalf of CMS for this audit and may reach out to your organization.

Required action and compliance

• Adhere to deadlines: CoventBridge Group will provide detailed instructions within their correspondence. You must submit all requested documentation according to the specific deadlines established in the letters.
• Verification and inquiries: Contact your managed care organization’s provider services line immediately if you have questions or require verification regarding a specific request. 

(pub. 6/12/26)

The Minnesota Department of Human Services has successfully identified and resolved system errors that were previously causing IEP claims to be incorrectly denied. School districts do not need to take any action or resubmit claims because we have automatically reprocessed impacted claims. 

• Error Code N290 for dates of service between Oct. 1, 2025, and Feb. 27, 2026: Reprocessed claims appeared on your May 5, 2026, warrant. 
• Error Code MA92 for dates of service from Oct. 1, 2025, through May 6, 2026: Reprocessed claims appeared on your June 2, 2026, warrant. 
• Error Code N30 covers dates of service between Oct. 1, 2025, and June 9, 2026: Payments will appear on your June 16, 2026, warrant.

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411, or via TTY at 711 or 800-627-3529 with questions about this message. (pub. 6/11/26)

The Minnesota Department of Human Services (DHS) invites lead agency staff and leadership to a large-group discussion that will focus on strengthening our partnership efforts to ensure all Minnesotans have met their health care needs. We will discuss continuity of care for people served by disenrolled providers, as well as ongoing engagement with providers to help them through the appeal process.

This meeting is an opportunity to: 

• Share updates on current processes and challenges.
• Discuss strategies to ensure uninterrupted care for affected people.
• Collaborate on solutions and align next steps across teams.

Lead agency’s participation and perspective are important as we work together to support a smooth transition and maintain high-quality care for those we serve.

The meeting will be held virtually through Microsoft Teams on Friday, June 12, 2026, from 9 to 10 a.m. Lead agencies will receive the meeting link after registration. 

DHS will host regular meetings to provide updates on topics related to program integrity and get feedback from lead agencies. The next meeting will be on Thursday, June 18, 2026, from 11 a.m. to noon. Lead agencies can register online for the future meeting. 

Review the Aging and Adult Service and Disability Services division eList announcement, Lead agency continuity of care meeting, for more information. (pub. 6/9/26)

The MN–ITS login move to LoginMN is tentatively scheduled for June 13, 2026. Minnesota Health Care Programs providers will use the LoginMN website after the move is complete to access MN–ITS. Do not use LoginMN to access MN–ITS until after the move is complete.

We included instructions in this message to assist providers with using this process for the first time. Follow these instructions if you are a current MN–ITS user. Additionally, the Accessing MN–ITS through LoginMN video explains these instructions with screenshots of the process.

Use the following instructions to access MN–ITS through LoginMN for the first time:

1. Locate the email you received for the MN–ITS email and phone number validation process. Make sure to check your spam and junk mail if you do not find the email in your inbox. Note: We posted the systems announcement ACTION REQUIRED: MN–ITS email and phone number validation, which included instruction for providers to complete this process, on the Provider news and updates webpage on Feb. 6, 2026.
2. Click the link in the email to start your LoginMN registration.
3. On the registration page, enter the email address where you received your LoginMN welcome email and click Send Code. We will email a verification code to the email address.
4. Locate the verification code and enter it in the Verification Code field.
5. Enter the password you want to use for your account in the New Password field and then reenter the password in the Confirm New Password field.
6. Set up multifactor authentication by selecting your preferred method of authentication. If you are not sure which option to choose, select Phone. Then click Continue. Note: We recommend not using the passkey option as losing your passkey will lock you out of your account.
7. Complete your multifactor authentication by following the prompts on your screen. If you selected the Phone option, choose either a phone call or a text message to receive your authentication code. If you selected Authenticator App, you will need to identify the app you are using and complete the process using that app to receive your authentication code.
8. Enter the authentication code you received in the Verification Code field and click Confirm code.
9. After confirming your code, you will be taken to the Minnesota Partner Apps website. We recommend bookmarking this website. Select DHS MN–ITS on your screen. 
10. Agree to the terms and conditions by checking the box and then click Continue.
11. If you have access to multiple NPI or UMPIs in MN–ITS, select the NPI/UMPI that you need to be active for this MN–ITS session and then click Continue. 
12. To choose a different NPI or UMPI, click the Logout button at the top of the MN–ITS home page to go back to the Minnesota Partner Apps webpage and select DHS MN–ITS. Then agree to the terms and conditions to display the NPI or UMPI selection screen again.

After completing your registration, use your bookmark for the LoginMN website. You will be prompted to log in using your email address and password. Additionally, any links to MN–ITS that you previously saved will automatically redirect you to the LoginMN website. (pub. 6/8/26)

The MN–ITS log in move to LoginMN is tentatively scheduled for June 13, 2026. SFTP users must register with LoginMN, following the steps outlined in the Welcome email from LoginMN. SFTP users must complete the registration and create a new password. After you successfully complete this registration, you should wait for 15 minutes before accessing any of your SFTP accounts. The password you set up during the LoginMN registration process is also your password for all your SFTP accounts. The SFTP username  has not changed.   

An example would be: 
Your new LoginMN username is the email you registered with, for example: Jane.Doe@email.com and your SFTP username is still JDoe@1234567890. 

If you have multiple SFTP accounts, you will have the same username for LoginMN for example: JaneDoe@email.com but your SFTP usernames will be: JDoe@1234567890, JDoe@2345678901, JDoe@A987654321.  

All accounts will use the same password you set up during the LoginMN registration process.

Refer to the FTP (File Transfer Protocol) Software Instructions for MN–ITS Batch Use section of the MN–ITS User Manual for more information. (pub. 6/8/26)

The Minnesota Department of Human Services sent certificates of completion to providers who completed the June 2-3, Waiver and Alternative Care (AC) Resources and MN–ITS Training sessions.

We sent the certificates to providers’ MN–ITS mailboxes under the national provider identifier (NPI) providers used to register for the training. Providers who completed the entire training should receive their certificate in their MN–ITS mailbox under “Miscellaneous Received” in the PRVLTR folder by the end of the business day June 5, 2026.

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411, option 4, if you have questions about this message. (pub. 6/5/26)

Midwives are an important part of maternity and family care in Minnesota, and the Minnesota Department of Health (MDH) and Minnesota Department of Human Services want to better support the workforce and expand access for birthing people and their families. 

We invite midwives to take the online 2026 Minnesota Midwife Workforce Survey to help us learn more about midwife practices, barriers to success, and ways to improve access to the field. The survey takes about 20 minutes to complete and ends on June 30, 2026. For completing the survey, you can choose to be entered into a random prize drawing.  

We will use this data for the following:

• Updating baseline demographic and workforce data.
• Identifying important needs of each workforce.
• Identifying important strengths of each workforce.
• Supporting strategic objectives to increase access to services.

We will post results on the Maternal Care Access webpage on the MDH website. (pub. 6/3/26)

The Minnesota Department of Human Services (DHS) received federal approval for the 2026 reimbursement rates for Personal Care Assistance (PCA) and Community First Services and Supports (CFSS) services backdated to Jan. 1, 2026. Federal approval includes the enhanced rates for PCA and CFSS and the enhanced budget in CFSS.

PCA Choice and financial management services (FMS) providers received a memo in their PRVLTR folder of their MN–ITS mailbox on May 28, 2026, titled: NPI/UMPI_PRVLTR_20260528_Tiered_minimum_wage_floors_for_PCA_and_CFSS_workers.pdf 

The memo included new tiered wage floors and additional information on the budget changes to the authorizations for CFSS budget model members. 

PCA Choice and CFSS budget model
Direct support workers serving members in PCA Choice and the CFSS budget model are now required to be paid the new minimum wages for hours worked on or after Jan. 1, 2026. PCA Choice agencies and FMS providers must pay direct support workers retroactively for hours worked since Jan. 1, 2026, to comply with the new minimum wage floor increases following federal approval of the reimbursement rates, including the enhanced rate and budget percentage (12.5%). PCA Choice agencies have been receiving the higher rate since Jan. 1, 2026, and must pay direct support workers retroactively within 31 calendar days from the memo date.

PCA Choice agencies and FMS providers must use the increase from the enhanced rate and budget percentage for wages and wage-related costs for workers whose services triggered the enhanced rate and budget. PCA and CFSS agencies and FMS providers may find instructions on the CFSS manual – PCA, CFSS and CSG enhanced rate budget webpage. 

DHS has made changes to the CFSS budget model to better support the payment of higher wages to more experienced workers. On June 1, 2026, we will add dollars to the budgets of CFSS budget model members based on the tier of the workers they've employed over the previous 11 months. At the end of each calendar quarter (April, July, October, January), we will add dollars to the member’s service authorization based on the experience level and hours worked of their employees in the previous calendar quarter.

PCA traditional and CFSS agency model
PCA traditional and CFSS agency model providers are already receiving tiered reimbursement rates for claims that include a worker in tiers L1–L4. The purpose of the tiered rates is for the increase to be used for wages and wage-related costs for the worker. PCA traditional and CFSS agency model providers are required to document that at least 72.5% of revenue received from PCA and CFSS reimbursement rates were used to pay worker wages and benefits. (pub. 6/1/26)

The Minnesota Department of Human Services is offering separate webinar sessions to demonstrate how to complete the Disability Waiver Rates System (DWRS) and Community First Services and Supports (CFSS) cost reporting for Minnesota Health Care Programs providers selected for this requirement.

DWRS Cost Reporting Demo and Q&A

• June 2, 2026, from 11 a.m. – noon
  Topic: DWRS Cost Reporting: How to prepare
• June 17, 2026, from 11 a.m. – noon
  Topic: DWRS Cost Reporting: Allocations

CFSS Cost Reporting Demo and Q&A
(all sessions contain the same information)

• June 3, 2026, from 10:30 a.m. – noon 
• July 15, 2026, from 10:30 a.m. – noon
• August 3, 2026, from 1 p.m. – 2:30 p.m.

DHS sent a memo on May 22, 2026, to the PRVLTR folder in the MN–ITS mailbox for all CFSS and DWRS providers that were selected for cost reporting in 2026. The memo included details on how to register for the DWRS and CFSS demo webinars. If you are a selected provider and want to attend one of the demonstrations, check your MN–ITS mailbox for the memo to register for the demonstration you want to attend. 

The deadline to complete cost reporting is Aug. 31, 2026. 

For questions about cost reporting, review the DWRS cost reporting or CFSS cost reporting webpages or email dhs.costreport@state.mn.us. 

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 5/27/26)

Minnesota Health Care Programs (MHCP) has resolved the system issue that incorrectly denied some CMDE claims for services billed with CPT codes 97151 UB, H0046 UB and T1024 UB when the CMDE treating provider was billed using a pay-to provider type 01 or 34.

MHCP will reprocess affected claims. Providers do not need to take any action at this time. Continue to watch your remittance advices for reprocessed claims.

Providers may call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 5/26/26)

The Minnesota Department of Human Services has extended the deadline for personal care assistance (PCA) and consumer support grant (CSG) members to transition to Community First Services and Supports (CFSS). Members who have not completed the transition to CFSS have until Sept. 30, 2027, to make this transition. 

Providers must review the current phase of the transition from PCA and CSG to CFSS to ensure their organization can provide CFSS services to PCA or CSG members when they transition. Providers can also review the following resources:

• What do current PCA provider agencies need to do?
• What do FMS providers need to do? 

The transition extension does not apply to the following:

• Members on Alternative Care can no longer use PCA services. So, this extension does not apply to them. 
• Members cannot use extended PCA services after Sept. 30, 2026. Extended PCA services are in addition to a member’s assessed services and are authorized by the member’s case manager. Providers will see extended PCA services on their authorization letters with a UC modifier code. 

For more information, refer to the March 25, 2026 and May 12, 2026 eList announcements.

Call the MHCP Provider Resource Center with any questions about this message at 651-431-2700 or 800-366-5411. (pub. 5/22/26)

The Minnesota Department of Human Services has learned that some providers have received phone calls from unauthorized parties requesting details about enrollment records and private health information, under the guise of completing the revalidation process. 

This scam appears to be exploiting the fact that our Provider Resource Center is making outbound calls to providers about revalidation. 

Department staff will never request patient or recipient information. As part of the revalidation process, the department may request information related to staff; however, this will not be collected over the phone. Requests will be limited to individuals who meet disclosure requirements (for example, those with at least a 5% ownership interest). The department may also ask about required professional or licensed affiliated staff, including their roles, responsibilities, and any affiliations with other Medicaid-enrolled organizations.

Please call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions or concerns. (pub. 5/22/26)

We have updated the MN–ITS eligibility response (271) to accurately show how many PT and OT visits members have used since Jan. 1, 2026. We reprocessed PT and OT claims with dates of service beginning Jan. 1, 2026. We have completed reprocessing claims and they will appear on the May 19, 2026, remittance advice. The claims reprocessing pulled a broad list of CPT codes which may have impacted services other than PT and OT, such as Early Intensive Developmental and Behavioral Intervention. There is no payment impact on non-PT and OT services.   

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. 5/22/26)

The Minnesota Department of Human Services sent certificates of completion to providers who completed either the May 5-6 or May 13-14, 2026, Waiver and Alternative Care (AC) Resources and MN–ITS Training sessions. 

We sent the certificates to providers’ MN–ITS mailbox under the national provider identifier (NPI) providers used to register for the training. Providers who completed the entire training should receive their certificate in their MN–ITS mailbox under “Miscellaneous Received” in the PRVLTR folder by the end of the business day May 20, 2026. 

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411, option 4, if you have questions about this message. (pub. 5/20/26)

Minnesota Health Care Programs (MHCP) has resolved the system issue affecting certain EIDBI claims that may have incorrectly denied with an invalid Place of Service 11 edit.

The issue affected claims billed with the following EIDBI CPT codes with modifier UB:

• 0373T 
• 97151 
• 97153 
• 97154 
• 97155 
• 97156 
• 97157 
• H0032 
• T1024 

Providers who had claims incorrectly deny for dates of service beginning Jan. 1, 2025, through May 6, 2026, due to this issue may do one of the following:

• Let DHS reprocess claims

OR

• Resubmit claims

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 5/20/26)

Minnesota Health Care Programs (MHCP) identified an issue affecting reimbursement rates for the following Early Intensive Developmental and Behavioral Intervention (EIDBI) service codes: 

• H0046 UB (Travel Time)
• H0032 UB (Individual Treatment Planning and Progress Monitoring)

Services billed under these EIDBI services codes from March 25, 2026, through April 28, 2026, were underpaid. We corrected the issue and the rates are paying appropriately as of April 29, 2026. Providers who have claims impacted by the underpayment can do one of the following: 

• Let DHS reprocess claims

OR

• Submit replacement claims

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 5/20/26) 

Minnesota Health Care Programs (MHCP) has resolved the system issue that incorrectly denied some EIDBI claims for services billed with CPT code H0046 UB.

Providers who had claims incorrectly deny due to this issue with dates of service beginning Dec. 16, 2025, through Jan. 27, 2026, can do one of the following:

• Let DHS reprocess claims

OR

• Resubmit claims

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 5/20/26)

The Minnesota Department of Human Services has contracted with Prime Therapeutics to serve as the single pharmacy benefit manager (sPBM) to administer the outpatient pharmacy benefit for Minnesota Health Care Programs members enrolled in managed care plans. The Minnesota Legislature during its 2025 session required we procure and implement a sPBM and we contracted with Prime Therapeutics after completing a competitive Request for Proposal process. 

Along with Prime Therapeutics and the managed care organizations, we are working to implement the sPBM model on Jan. 1, 2028. Note, Prime Therapeutics processes claims for the fee-for-service program; however the sPBM contract and work is separate from the fee-for-service existing contract and system. We will provide additional information including timelines, milestones, billing instructions and provider training and materials throughout the next several months. (pub. 5/20/26)

Minnesota Health Care Programs (MHCP) is changing the authorization requirements for manual transanal irrigation systems (A4459) and rectal catheters (A4453) under the Urological and Bowel Supplies section of the MHCP Provider Manual effective July 1, 2026.

Manual transanal irrigation systems and catheters defined by HCPCS codes A4459 and A4453 currently require authorization always. Effective July 1, 2026, authorization is only required for excess quantities for manual systems and catheters. MHCP covers one manual system per dispensing, up to four systems per year. MHCP covers up to 31 rectal catheters per month before authorization is required.

Electronic transanal irrigation systems (A4479) always require authorization. Members must meet criteria. Documentation must show that the member cannot operate a manual system and can operate an electronic system independently.

Refer to information under the Covered Services heading in the Urological and Bowel Supplies section of the MHCP Provider Manual for coverage information. Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 5/19/26)

The Minnesota Department of Human Services Office of the Medicaid Medical Director (OMMD), in partnership with the University of Colorado Anschutz Medical School, is conducting a survey to understand how Minnesota Health Care Programs providers experienced the period of heightened federal immigration enforcement activity between December 2025 and February 2026. We are inviting providers to participate because your perspective as a health care professional is invaluable to the care Minnesotans receive. Refer to the Health care delivery during immigration enforcement activity in Minnesota (PDF) for more information and go to Immigration Enforcement Activity - Provider Survey to complete the survey. The survey closes June 26, 2026. We will not collect personally identifying information and survey respondents will remain anonymous. (pub. 5/18/26)

Eligible outpatient Minnesota pharmacies that meet requirements for the managed care organization (MCO) to pay the direct dispensing payment of $4.50 per filled prescription must complete the Directed Pharmacy Dispensing Payment Assurance Statement (DHS-8750) (PDF) and fax to 651-431-7462 by July 24, 2026, per Minnesota Statutes, 256B.69, subdivision 6i. MCOs will begin making payments to pharmacies as early as August 2026. 

To be eligible, pharmacies must be enrolled as an MHCP provider, be located in Minnesota, not be directly or indirectly owned by a pharmacy benefit manager or health carrier, and one of the following:

• Be located in a medically underserved area as defined by United States of Department of Health and Human Services Health Resources and Services Administration (United States Code, title 42, section 254).

OR

• Must not have more than 13 locations in Minnesota

Pharmacies must be enrolled with an MCO that contracts with the Minnesota Department of Human Services. Refer to the MCO contacts for MHCP providers webpage for a list of MCOs. (pub. 5/18/26)

The Minnesota Department of Human Services has sent providers who registered for the May 13-14 Waiver and Alternative Care (AC) Resources and MN–ITS Training their invitation links. You will receive two separate email invitations, one for each day. We sent the invite links May 12, 2026, via email to the email address you entered during the registration process. You will need to use the correct invitation link to join on the appropriate day.

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411, option 4, if you have questions about this message. (pub. 5/12/26)

Minnesota Health Care Programs (MHCP)-enrolled providers can currently bill obstetric services either globally (bundled coding) or by component; however, the American Medical Association (AMA) is eliminating the global CPT codes effective Jan. 1, 2027. Providers have until Dec. 31, 2026, to access the global codes.

Global codes bundle all prenatal visits, delivery, and postpartum care into a single claim. Under the new system, each phase of care — prenatal, labor management, delivery, and postpartum — will be billed separately as services are provided. The Minnesota Department of Human Services will follow updated billing guidance from the American College of Obstetricians & Gynecologists (ACOG). 

ACOG recommends providers switch to billing by component for members who begin prenatal care in 2026 and are expected to deliver in 2027. 

• For members who begin prenatal care in 2026 and are expected to deliver in 2027, providers should bill each prenatal visit using the appropriate Evaluation and Management (E/M) code (99202–99499); and append the TH modifier to indicate the visit is for obstetric care. ACOG recommends providers begin this by June 1, 2026, and no later than Sept. 1, 2026.
• Providers can separately bill services that were previously bundled into the global code, including nutrition counseling and other medically necessary services, in the new coding structure. Bill these using the appropriate codes with the E/M visit.

Timeline

• June 1, 2026: Providers are encouraged to begin billing prenatal visits with E/M codes (99202–99499) + TH modifier 
• Sept. 1, 2026: Providers are encouraged to fully transition to using the appropriate E/M codes (99202-99499) + TH modifier.
• Jan. 1, 2027: Global obstetric care services codes are no longer valid. The Minnesota Department of Human Services fully transitions to the new AMA coding methodology. 
• Refer to ACOG Maternity Care Coding Resources for guidance and tools to support this transition. 

For providers who are unable to meet this timeline, ACOG issued the following recommendations for how to continue billing bundled codes in 2026 for pregnant people who are expected to deliver in 2027:

• May 15 to July 14, 2026: Use CPT code 59426 with new delivery only codes to account for anticipated 7 or more prenatal visits 
• July 15 to Sept. 1, 2026: Use CPT code 59425 with new delivery only codes to account for anticipated 4 to 6 prenatal visits
• Sept. 1, 2026, and onward: Full transition to Evaluation and Management (E/M) codes as it is likely obstetric providers will only provide 1 to 3 prenatal visits before delivery

Informational meetings

The Minnesota Department of Human Services will host informational meetings to educate providers on the upcoming coding changes. We invite you to attend one of the following meetings for more information.

• May 14, 2026, from 12:15 to 1 p.m. (central time). Register for the May 14, 2026, meeting. 
• May 21, 2026, from 12:15 to 1 p.m. (central time). This meeting will include an ACOG representative. Register for the May 21, 2026, meeting. 

Future trainings will be provided this summer. 

Call the MHPC Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 5/8/26)

Minnesota Health Care Programs (MHCP) requires providers to use modifier GO to indicate occupational therapy services and GP to indicate physical therapy services for fee-for-service claims. GO and GP are used whether the service was provided by a therapist or an assistant. Use modifier U7 when an assistant provides services at any time without the supervising therapist on site. 

You must include appropriate modifiers on the authorization request and claim, and the authorization request and claim must match. Contact the medical review agent Acentra or by calling 866-433-3658 if an authorization is approved and the claim gets denied due to modifiers not matching the authorization.

Authorization requests made to MHCP when a member has third-party liability (TPL) or Medicare must exactly match what was billed or requested through the TPL or Medicare. This includes using modifiers KX, CO and CQ when appropriate. Refer to the TPL and Medicare policy for specific guidelines. Review the Codes and Modifiers section of the Rehabilitation Services section of the MHCP Provider Manual for a full list of modifiers. 

Example of an authorization request
CPT 97161 1 unit GP 5/1/2026 – 6/30/2026
CPT 97110 14 units GP U7 5/1/2026 – 6/30/2026
CPT 97110 4 units GP 5/1/2026 – 6/30/2026
CPT 97140 14 units GP U7 5/1/2026 – 6/30/2026
CPT 97140 4 units GP 5/1/2026 – 6/30/2026

(pub. 5/5/26)

The 2025 legislative session included multiple changes that have a planned effective date of July 1, 2026, which affect all providers of SUD services. The following changes are pending federal approval before becoming effective:

• New types and descriptions for SUD treatment services for all SUD providers
• New billing codes and procedures for outpatient SUD providers

Refer to the Information on 2026 Changes (PDF) listed under the News and Current Reminders heading on the Substance Use Disorder Reform webpage for information about and to prepare for the upcoming planned SUD changes.

Email questions about this message to sud.direct.access.dhs@state.mn.us or contact the Minnesota Department of Human Services policy area that oversees your program type. (pub. 5/5/26)

We recommend providers check their MN–ITS mailbox regularly for important correspondence from Minnesota Health Care Programs (MHCP). MHCP delivers the following provider information electronically to each provider’s MN–ITS mailbox account. 

• Provider news and updates
• Enrollment letters
• Medical, dental and service authorization letters
• Remittance advices

Providers are required to verify member eligibility. Use MN–ITS or call the automated Eligibility Verification System at 651-431-2700 or 800-366-5411 option 1. Review the Verifying MHCP Eligibility in MN–ITS and Understanding Eligibility Results in MN–ITS videos for more information.

The department is launching a new e-newsletter for providers titled MHCP Provider Connect: A weekly roundup of news, updates and reminders to keep Minnesota Health Care Programs providers informed of developments at the Minnesota Department of Human Services. Our goal is help keep you aware of changes that impact your work and the communities we serve together. Sign up for email alerts on the Email Updates webpage to have these emails sent directly to your inbox.

View more news and updates.

We keep provider news messages on the Minnesota Department of Human Services website for one year. Refer to the Provider news and updates archive webpage to view archived messages.

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. 1/13/26)