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.

Any providers of the 13 high-risk services who received a Request for More Information (RFMI) letter must submit all the information requested within 30 days of the date on the letter. We sent the final batch of RFMI letters to providers’ MN–ITS mailboxes in April. Failure to submit all of your information within 30 days will result in disenrollment from providing services through MHCP. (pub. 5/13/26)

Minnesota Department of Human Services (DHS) received approval from the federal Centers for Medicare & Medicaid Services (CMS) to extend the temporary moratorium on enrolling new EIDBI provider agencies.

The moratorium, effective beginning Nov. 1, 2025, is now extended through Oct. 31, 2026. DHS will not enroll any new EIDBI provider agencies during this time. All new enrollment submissions received during the moratorium will be denied. 

EIDBI agencies enrolled before Nov. 1, 2025, may continue to enroll new locations. Individual EIDBI providers may still enroll if they meet all applicable requirements. 

The moratorium may be extended in additional six-month increments, if necessary, with CMS approval. Refer to article 6 of the Minnesota Session Laws – Chapter 9 webpage for more information.

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. 4/29/26)

The Minnesota Department of Human Services has created a Frequently asked questions (FAQs) for providers webpage about Minnesota Revalidate 2026. Refer to these FAQs for the most current information about the revalidation process, unannounced site visits, documentation, background studies, Minnesota Provider Screening and Enrollment portal and NETStudy 2.0. (pub. 4/13/26)

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Minnesota Health Care Programs (MHCP) has rescheduled the May 21, 2026, Provider Basics Training to May 28, 2026. We rescheduled the original May 21, 2026, because our system will be down for maintenance at that time. 

Register for the rescheduled Thursday, May 28, 2026, webinar at: Provider Basics Training Registration.

We apologize for any inconvenience this may cause and appreciate your understanding.

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 5/13/26)

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)

All Early Intensive Developmental and Behavioral Intervention (EIDBI) provider agencies that have not yet submitted a provisional license application must submit an application immediately to remain enrolled and eligible to provide EIDBI services through Minnesota Health Care Programs (MHCP).

Deadline: May 31, 2026
Your agency must submit a complete provisional license application on or before May 31, 2026. Failure to meet this deadline will result in termination from being an enrolled MHCP EIDBI provider agency effective June 1, 2026.

If your agency is terminated:

• You must immediately cease providing all EIDBI services through MHCP of June 1, 2026
• You must not bill MHCP for any EIDBI services provided on or after June 1, 2026
• Claims submitted for dates of service on or after June 1, 2026, will be denied and subject to recoupment

No exceptions or extensions will be granted.

Required Action

• Verify whether your agency has submitted a provisional license application
• If you have not submitted an application, create a Provider Hub account and submit your application immediately to ensure it is received by the deadline

Agencies that fail to submit a provisional license application by May 31, 2026, will not be authorized to operate or receive reimbursement through MHCP for EIDBI services beginning June 1, 2026. Additionally, failure to comply with this requirement will result in enforcement action, including termination of enrollment and recovery of funds for noncompliant billing.

Submit your provisional license application now to avoid disruption to your agency’s operations and services.

Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. Contact DHS EIDBI Licensing at 651-431-6500 or eidbi.licensing.dhs@state.mn.us if you have questions about submitting an application for a provisional license. (pub. 5/1/26)

The Minnesota Department of Human Services has sent providers who completed the April 21-22, 2026, Waiver and Alternative Care (AC) Resources and MN–ITS Training session their certificates of completion. 

We sent the certificates to providers’ MN–ITS mailbox for 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 April 28, 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. 4/29/26)

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 25-27, 2026, their certificates of completion. 

We sent the certificates to the email address the attendee used at the time of registration 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 23, 2026. 

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 4/23/26) 

The Minnesota Department of Human Services has approved an update to the list of cost-effective generic medications that may be dispensed in a quantity sufficient for a 90-day supply to fee-for-service Medical Assistance members as of April 24, 2026. Dispense of a 90-day supply is not mandatory. All medications not found on this list continue to be limited to a maximum of a 34-day supply per Minnesota Statutes 256B.0625, subdivision 13(b). Refer to the 90 Day Supply Prescription Drug List under Forms and Documents on the Minnesota Medical Assistance Portal for the updated list. (pub. 4/22/26)

The Minnesota Department of Human Services has contracted with Myers and Stauffer, LC, a national certified public accounting firm, to conduct pharmacy surveys to establish and maintain the Minnesota Actual Acquisition Cost (MNAAC) program.

Beginning Jan.  1, 2027, Minnesota fee-for-service Medical Assistance is required to incorporate MNAAC into drug ingredient cost reimbursement algorithms (Minnesota Statutes, 256B.0625, subdivision 13e). All Minnesota Health Care Programs enrolled pharmacies will be included in the initial survey beginning in July 2026, and will be selected to complete ongoing quarterly surveys at least once per calendar year thereafter. Participation is mandatory, and sanctions may be applied to non-respondent pharmacies (Minnesota Statutes, 256B.0625, subdivision 13e(i)). Information sessions will begin in June 2026. 

Contact Myers and Stauffer via e-mail at pharmacy@mslc.com for more information. (pub. 4/22/26)

We revised this message with an updated application deadline of July 1, 2026, and that providers should refer to the “TMaH Model Changes_April 2026” document sent to the TMaH list serv for important updates. 

The Minnesota Department of Human Services invites you to apply for the Transforming Maternal Health Model (TMaH). TMaH is a new value-based payment model from the Centers for Medicare & Medicaid Services (CMS) designed to address gaps in maternal health access, quality, and whole-person care through Medicaid. CMS awarded 15 states in 2025, including Minnesota through the Office of the Medicaid Medical Director. The model will pilot in Hennepin County. 

We will accept applications online (Apply to participate in TMaH) now through July 1, 2026.

Providers should also refer to the “TMaH Model Changes_April 2026” document sent to the TMaH listserv for important updates. 

TMaH providers receive the following: 

• Technical assistance and training 
• Provider Infrastructure Payments to prepare for value-based payment transformation 

With options for contract renewal for:

• Provider Infrastructure Payments
• Upside-only performance incentives 
• Value-based payment (VBP) transformation 

This value-based payment model will change the way organizations are paid for certain perinatal MA patients. 

In a landscape where maternal health gaps are widening for some Minnesotans and we are facing unprecedented policy and funding changes, we must be strategic with our collaboration, initiatives, and practice. Through TMaH, we aim to bring people together to transform access, quality, and delivery of whole-person maternal care in Hennepin County. 

Note, CMS guidance on the proposed VBP strategy is still being finalized, and changes may occur from initial proposals. We have shared Minnesota’s feedback on the proposed strategy through our cooperative agreement with CMS. Further CMS guidance will likely address this feedback and the pending unbundling of the global maternity rate (to occur Jan. 1, 2027).

Visit the Minnesota Transforming Maternal Health Model webpage to learn more about applying, eligibility requirements, and the model. (pub. 4/1/26, rev. 4/22/26)

ICF/DD providers should check their MN–ITS mailboxes for a memo titled “April 21, 2026, payment” dated April 17, 2026. (pub. 4/21/26)

Minnesota Health Care Programs (MHCP) updated coverage criteria for insulin infusion pumps under the Diabetic Equipment and Supplies section of the MHCP Provider Manual. 

Insulin infusion pumps are covered for members with insulin-dependent diabetes and who demonstrate poor glycemic control despite monitoring of blood glucose levels. MHCP removed requirements for c-peptide or beta cell testing, self-testing of four times per day, and self-injections of three times per day. Refer to the Covered Services for complete coverage criteria. 

These changes in coverage criteria impact the coverage criteria of external insulin infusion pumps. External insulin infusion systems are covered for members who meet criteria for insulin infusion pumps and whose medical needs cannot be met without an external system. Documentation must articulate why insulin infusion pumps do not suffice for medical necessity and why the tubeless option is required. 

Refer to the Diabetic Equipment and 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. (4/21/26) 

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 all news and updates.

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)