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
We will update this section with information about MN–ITS availability, technical information and other systems announcements when necessary.
Effective Jan. 1, 2025, Early Intensive Developmental Behavioral Intervention (EIDBI) Level I providers with a BCBA or BCBA-D certification must be licensed as an LBA from the Minnesota Board of Psychology. Currently enrolled BCBA and BCBA-D certified providers must submit the following required documentation by April 30, 2025, to remain in compliance and continue providing services. Minnesota Health Care Programs (MHCP) Provider Eligibility and Compliance may suspend billing or terminate providers who are out of compliance.
Additionally, effective Jan. 1, 2025, Level 1 LBA providers are eligible to provide QSP services. Individual providers and provider agencies must complete the appropriate process listed under For licensed behavior analysts enrolling as qualified supervising professionals heading.
For EIDBI Level I providers (BCBA or BCBA-D certification update):
Failure to provide proof may impact your ability to provide EIDBI services, including billing and program continuation.
Submit your license promptly to avoid delays in processing.
Upload your documentation in the Minnesota Provider Screening and Enrollment (MPSE) portal Credentials page.
Licensure verification: MHCP Provider Eligibility and Compliance will convert your license type after a scheduled systems update in the MPSE portal in April 2025.
For licensed behavior analysts enrolling as qualified supervising professionals:
Licensed behavior analysts (LBAs) acting as qualified supervising professionals (QSPs) are responsible for developing and overseeing comprehensive treatment plans and supervising EIDBI services.
LBAs who want to enroll as a QSP must complete the following process:
The Minnesota Department of Human Services (DHS) has sent providers who attended the entire Community First Services and Supports (CFSS) Steps for Success workshop on March 19-21, 2025, their certificates of completion.
DHS sent the certificates to the email address used to register for the March CFSS Steps for Success workshop. Providers who completed the entire training should have received their certificate by the end of the business day April 21, 2025.
Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 4/22/25)
The Minnesota Department of Human Services (DHS) will be offering a training on integrated community supports (ICS). The two-hour training will provide a comprehensive review of requirements for providers delivering ICS services and lead agencies authorizing ICS services.
Topics covered will include:
ICS setting requirements
Site-specific review requirements
The home and community-based services (HCBS) settings rule and how it relates to ICS
ICS service authorizations and rates
Service delivery requirements
The training will be offered on Wednesday, May 21, 2025, from 10 a.m. to noon. Register for the training at ICS training registration. (pub. 4/22/25
The Minnesota Department of Human Services identified that an overpayment occurred for critical access dental claims submitted on April 1, 2025. We resolved this discrepancy and reprocessed the impacted claims. The corrected payments appeared on the April 22, 2025, warrant. (pub. 4/22/25)
MHCP is changing from medical (CPT) codes to dental (CDT) codes for how dental implants are coded for reimbursement effective Jan. 1, 2025.
We made this decision to align MHCP policies with current best practices and recommendations from the Centers for Medicare & Medicaid Services. All dental implants must be medically necessary and the least expensive treatment option. Implants require prior authorization always, including the restorative treatment plan.
Providers do not need to take any action at this time. (pub. 4/17/25)
The Intensive Residential Treatment Services (IRTS) and Adult Residential Crisis Stabilization (RCS) room and board rates were incorrectly listed on the Mental Health Codes and Rates Grid, dated March 1, 2025.
Minnesota Health Care Programs corrected the grid to reflect the current IRTS and Adult RCS room and board rates of $55.72. Review the corrected Mental Health Codes and Rates Grid.
We have paid and are currently paying the IRTS and Adult RCS room and board rates at the correct rates. There is no known impact on claims. We will continue to monitor claims to ensure they are paid correctly. (pub. 4/16/25)
We have revised this message to correct the MNNEMT@mslc.com email address. The Minnesota Department of Human Services (DHS) has contracted with Myers and Stauffer LC to review NEMT provider claims for compliance with state and federal requirements. DHS and Myers and Stauffer LC will conduct provider outreach throughout 2025 with the goal of reviewing NEMT programs in 2025.
Providers do not need to take any action at this time. We will contact you directly if you are selected for review.
MHCP has published a surgical dressings section of the MHCP Provider Manual. Surgical dressings are used to treat wounds, lesions, ulcers, or other medical conditions requiring dressings.
Refer to the Surgical Dressings section of the MHCP Provider Manual for specific coverage criteria.
Effective May 1, 2025, MHCP requires providers to use modifiers A1 to A9 to indicate the number of wounds, lesions, or ulcers on which a dressing is being used. Bill the total number of units for a particular HCPCS code with the appropriate A modifier. The Medical Supply Coverage Guide (PDF) has been updated to clarify that the quantity limits listed are per wound, lesion, or ulcer, and the monthly quantity limit, if applicable.
Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 4/11/25)
In 2021, the Minnesota Legislature established a utilization benchmark for managed care organizations (MCOs) and county-based purchasing plans that contract with the Minnesota Department of Human Services (DHS) to administer the dental benefit in Medical Assistance (MA) (Minnesota Statutes, 256B.0371). The benchmark is 55 percent utilization in the aggregate (all plans) for calendar year 2024. The legislation requires DHS to contract with a single dental benefit administrator (DBA) for Minnesota Health Care Programs (MHCP) on Jan. 1, 2026, if the benchmark is unmet.
In order to meet the potential January 2026 deadline, some initial planning work is required. As a result, we issued a request for proposal to plan a potential transition to a single DBA. We completed the review process and selected Delta Dental of Minnesota as the DBA.
If the 55 percent benchmark is met, the single DBA will not move forward. If the benchmark is not met, the single dental administrator would go into effect Jan. 1, 2026. This would apply to all MHCP members, which includes members with coverage from MA, MHCP fee-for-service, managed care, Program HH, MinnesotaCare or county-based purchasing.
Providers do not need to take any action at this time.
We will provide updates and instructions throughout the coming months. (pub. 4/3/25)
Minnesota Health Care Programs has updated its system and will reprocess critical access mental health claims for dates of service between Jan. 1, 2025, and Jan. 14, 2025. Impacted claims will be adjusted according to the “Legislative update: Critical access mental health rate add-on elimination schedule” message posted on the Provider news and updates (PDF) webpage Jan. 10, 2025.
You do not need to take further action while we reprocess claims. The reprocessed claims will appear on the April 11, 2025, remittance advice. (pub. 4/3/25)
Minnesota Health Care Programs (MHCP) has started reprocessing claims according to the Behavioral Health Homes (BHH) claims reprocessing provider news message that we published March 6, 2025.
You do not need to take further action. Reprocessed claims will appear on your March 25, 2025, and April 11, 2025, remittance advices.
Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 4/3/25)
We have revised this message to announce the Community First Services and Supports (CFSS) weekly questions and answers sessions held Thursdays from 11 a.m. to noon have ended. The CFSS weekly Q&A sessions will combine with the CFSS provider agency office hours being held biweekly on Tuesdays from 11 a.m. to noon.
The newly combined office hours will be jointly hosted by CFSS policy and provider enrollment staff, who will answer questions about the PCA to CFSS transition and other policy questions as well as questions about CFSS provider enrollment.
Upcoming CFSS provider agency office hours will be held on the following dates:
HealthPartners will no longer be a health plan option for Special Needs BasicCare (SNBC) members beginning April 1, 2025.
Approximately 4,300 HealthPartners SNBC members in the counties of Anoka, Benton, Carver, Chisago, Dakota, Ramsey, Scott, Sherburne, Stearns, Washington and Wright will be moved to and will access their health care services though Medical Assistance fee-for-service beginning April 1, 2025. Many of these members have existing authorizations through HealthPartners, and Minnesota Department of Human Services (DHS) will honor most of these existing authorizations.
DHS asks providers to help members transitioning from HealthPartners by submitting authorization requests to DHS’s authorization agents so these members may continue receiving services.
What do providers need to do for transition to fee-for-service?
Members who have approved authorizations with HealthPartners for services on or after April 1, 2025, will need new authorizations from Minnesota Health Care Programs (MHCP).
If you are currently an MHCP-enrolled provider, submit authorization requests to our authorization agents, Acentra Health for medical or dental or Prime Therapeutics for physician administered drugs. If the services were authorized by HealthPartners, include a copy of the approval notice. Refer to the MHCP Provider Manual sections for Authorization or Drug Authorization process and documentation requirements for services that were not authorized by HealthPartners.
If you are an MCO In-Network only provider and want to continue to provide service to your member, you will first need to Enroll with MHCP. Once you are approved and enrolled with MHCP, you should submit an authorization request.
Minnesota Health Care Programs (MHCP) sent a memo and spreadsheet to some consultation services providers on March 28, 2025, about claims submissions. Providers will find the memo and spreadsheet in their PRVLTR folder in their MN–ITS mailbox. The memo will provide further information and instructions.
You do not need to take any action if you did not receive a memo.
Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have any questions about this message. (pub. 3/28/25)
Minnesota Department of Human Services (DHS) updated its claims system to pay for personal care assistance (PCA) and Community First Services and Supports (CFSS) agency model services at the tiered reimbursement rates. We recently advised PCA and CFSS providers that these updates were effective on March 12, 2025. We later discovered an additional programming change was necessary for the tiered rates to pay correctly. This programming change will be completed within the current billing cycle. PCA and CFSS provider agencies will begin to see claims reflecting the tiered reimbursement rates on their April 8, 2025, remittance advice.
DHS will automatically reprocess PCA and CFSS agency model claims starting with dates of service Jan. 1, 2025, after the programming is complete. Providers will see the reprocessed claims for services provided by workers in tiers L1 – L4 on their April 22, 2025, remittance advice. PCA and CFSS agency providers will receive the appropriate reimbursement based on the worker’s tier with the retroactive claims reprocessing.
DHS will send PCA and CFSS provider agencies and workers a notification letter when an affiliated worker changes tiers. We will mail letters to workers via the U.S. Postal Service and send letters electronically to the affiliated provider agencies’ MN–ITS mailboxes. We mailed the first iteration of these letters to both workers and their affiliated provider agencies via the U.S. Postal Service, but we will not mail letters to affiliated provider agencies via the U.S. Postal Service in the future. We will send them to affiliated provider agencies’ MN–ITS mailboxes.
Refer to the Update Tiered Wage memo we sent to PCA and CFSS providers’ MN–ITS PRVLTR folder March 21, 2025, for more information about the wage floor requirements for PCA Choice and the CFSS budget model. Refer to the PCA and CFSS tiered rates and wage floors webpage for more information about the tiered reimbursement rates. (pub. 3/27/25)
Minnesota Health Care Programs (MHCP) added coverage criteria and updated authorization requirements for upper limb prosthetics effective April 1, 2025.
MHCP covers passive, body-powered, and myoelectric devices for eligible Medical Assistance and MinnesotaCare members. Refer to the Orthotics and Prosthetics section of the MHCP Provider Manual for more detailed policy information.
MHCP is changing prior authorization requirements for several upper limb prosthetics (HCPCS) from sometimes to always required. Authorization is now required for these HCPCS:
Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad (L6050)
Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad (L6055)
Minnesota Health Care Programs (MHCP) has identified a system issue affecting claims for mode 3 transportation submitted by county and tribal agencies and transportation brokers. This issue specifically impacts claims with mileage procedure code S0215.
In a correction to the Provider News posted on January 24, 2025, we clarify that this issue affects only mode 3 transportation claims, not mode 4. Providers should continue billing mode 3 transportation as usual, using procedure code A0100 combined with S0215. Note that while the mileage line (S0215) will deny, the base rate line (A0100) will still be paid.
We are actively working to resolve this issue. Once corrected, we will reprocess the affected claims and publish an updated Provider News announcement confirming the date we have reprocessed the denied mileage lines on affected claims. (pub. 3/17/25)
This is a follow-up to the Feb. 14, 2025, Provider News regarding the enrollment of licensed behavior analysts (LBAs) as qualified supervising professionals (QSPs) for Early Intensive Developmental and Behavioral Intervention (EIDBI) services.
LBAs serving as QSPs are responsible for developing and monitoring comprehensive treatment plans, supervising applied behavior analysis services, and ensuring high-quality, individualized care for individuals receiving EIDBI services.
Next Steps for LBA Providers Enrolling as QSPs:
Review the Level I, II and III EIDBI Providers section of the EIDBI Enrollment Criteria and Forms page for information on which credentials and services are required to be added to individual records.
Agencies affiliating an LBA as a QSP must also complete and submit the EIDBI Provider Agency Assurance Statement (DHS-7120B) (PDF) to Minnesota Health Care Programs and add the QSP as a managing employee for the EIDBI enrollment record.
To submit the DHS-7120B using MPSE, follow the instructions to complete an Enrollment Record Request in the organization’s portfolio. When completing the enrollment record request, organizations can add the QSP to the Owners and Authorized Persons page with the Managing Employee role type.
Minnesota rates for substance use disorder (SUD) treatment services have changed due to approval of state plan amendments. State plan amendment changes included:
Minnesota has adopted the 1115 SUD waiver base rates to be used for SUD treatment services where applicable. This change allows services provided to Behavioral Health Fund recipients (major program OO) to be paid at the same rate as Medical Assistance (MA) recipients.
Resubmit claims for residential treatment services for members in major program OO Behavioral Health Fund
Residential services providers must resubmit claims for major program OO for dates of service July 1, 2024 through Feb. 28, 2025, using the current value 24 code from Residential Value Codes for Billing Direct Access table to be reimbursed at the higher rate.
Nonresidential/outpatient services
DHS has already reprocessed nonresidential claims with dates of service beginning Jan. 1, 2025.
The reprocessed claims will show up on your Remittance Advice for March 14, 2025.
Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have any questions about this message. Email questions about state plan amendments, SUD residential and outpatient rates to sud.direct.access.dhs@state.mn.us (pub. 3/13/25)
The Community First Services and Supports (CFSS) weekly questions and answers sessions being held on Thursdays from 11 a.m. to noon will end on March 27, 2025.
Starting April 8, 2025, the CFSS weekly Q &A sessions will combine with the CFSS policy and provider agency office hours being held biweekly on Tuesdays from 11 a.m. to noon.
The newly combined office hours will be jointly hosted by CFSS policy and provider enrollment staff, who will answer questions about the PCA to CFSS transition and other policy questions as well as questions about CFSS provider enrollment.
Upcoming CFSS provider agency office hours will be held 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.
In March, there are two training sessions available for personal care assistance (PCA) providers on how to revalidate using the Minnesota Provider Screening and Enrollment (MPSE) portal. These trainings are for PCA providers who have received their revalidation notice from Minnesota Health Care programs (MHCP) and wish to add Community First Services and Supports (CFSS) to their enrollment record. The trainings explain revalidation requirements and offer a live demonstration in MPSE.
You can register for future trainings in 2025 on this topic on the MPSE portal training website.
Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with any questions. (pub. 3/3/25) (pub. 3/25/25)
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. We have scheduled 2025 training sessions for the following:
Child and Teens Checkups
Community Mental Health Workers
Consultation Services
Dental Services
Doula
Early Intensive Developmental and Behavioral Intervention
Federally Qualified Health Centers and Rural Health Clinics
Financial Management Services
Home Care
Housing Stabilization Services
Housing Support Supplemental Services
Individualized Education Program Services
Mental Health
Nursing Facilities
Personal Care Assistance/Community First Services and Supports agencies
Minnesota Health Care Programs (MHCP) is offering free online Provider Basics Resources and MN–ITS training to all enrolled MHCP providers who bill fee-for-services claims. This training is being offered monthly beginning Mar. 10, 2021.
You will learn how to navigate the MHCP provider webpages and the MHCP provider manual, and how to use MN–ITS administration, mailbox and eligibility requests (270/271) features. Go to the Provider Basics webpage to register for this training.
Claim training is not provided in this training. Refer to the MHCP provider training webpage to register for provider-specific claim training. (pub. 2/11/21)
Minnesota Health Care Programs (MHCP) offers free on-demand training videos arranged by category on the MHCP provider training webpage. Each video can be viewed in about 10 minutes and provides instructions on a concept or technique. The following new videos are available:
Request for More Information (RFMI) – This video shows a provider how to find an RFMI in their MN–ITS mailbox and in the Minnesota Provider Screening and Enrollment (MPSE) portal.
Minnesota Health Care Programs provides free online training for our MPSE online portal. We have scheduled training sessions for 2025. Visit the MPSE portal training webpage to review the schedule, register for a training session, view brief online tutorials to help prepare you for class and more information. (pub. 12/17/24)
