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.
In April, 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. The trainings are scheduled for the following dates:
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. 4/2/25)
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. Starting April 8, 2025, 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)
On March 14, 2025, Minnesota Health Care Programs (MHCP) sent memos to some consultation services providers about claims submissions. Providers who will receive the memo will find it in their PRVLTR folder in their MN–ITS mailbox. The memo will provide further information and instructions.
If you did not receive a memo, you do not need to do anything.
If you have any questions, contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411. (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)
Effective Jan. 1, 2025: Annual adjustments from the midpoint of the rate year, utilizing the Centers for Medicare and Medicaid Services Medicare Economic Index, as forecasted in the fourth quarter of the prior calendar year. Refer to the Notes column in the Mental Health Codes and Maximum Adjusted Fee For Service Rate by Date of Rate Change (PDF), where sections are marked with D, for more information.
We will reprocess claims and you do not need to take any further action.
Refer to the following headings in the Payment Methodology – Non-Hospital section of the Minnesota Health Care Programs (MHCP) Provider Manual for more details.
Legislative Changes Related to Rates
Mental Health
Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 3/10/25)
The Minnesota Department of Human Services has a new online form for the Local County or Tribal Agency Monthly Transportation Report (DHS-8214). Lead agency providers should know the following:
Updating of records and bookmarks is critical: Providers should update records and bookmarks with the new link. The previous online form link will be unavailable soon.
The Minnesota Department of Human Services (DHS) now has a frequently asked questions (FAQs) resource for MH-SPED available on the School Mental Health Services webpage.
The FAQs resource answers questions about services and providers; billing and Medical Assistance; documentation; treatment supervision; and includes additional resources for MH-SPED. MH-SPED refers to mental health services provided through an Individualized Education Program or Individualized Family Service Plan. These services, as detailed in the Minnesota Health Care Programs Provider Manual, are specific assessments and interventions provided when determined to be medically necessary by qualified professionals in an educational setting.
The Minnesota Department of Education and DHS will hold their next virtual Office Hours from 3 to 4 p.m. on Monday, March 10. Office hours are held the second Monday of each month via Webex and are intended for any school staff throughout Minnesota to receive guidance in navigating new and existing behavioral health opportunities. (pub. 3/7/25)
Minnesota Health Care Programs (MHCP) has identified an internal duplicate fee-for-service payment error of the 3 percent increase for BHH services (refer to Minnesota Statutes, 256B.761 (e)) backdated to date of service Jan. 1, 2024, and will take back payments we paid in error.
Correct payments will appear starting with your March 14, 2025, remittance advice (RA). We will continue to reprocess claims, and any takeback amounts will be shown on future RAs. You do not need to take any further action. We will post a follow-up message after the reprocessing is complete. (pub. 3/6/25)
All providers required to complete electronic visit verification (EVV) with an HHAeXchange portal will transition to redesigned software in March. This update is designed to improve your experience, streamline workflows, and enhance overall system functionality without disrupting services.
Beginning March 3, 2025, provider portals began migrating to the redesigned HHAeXchange software. No action is required from you. The transition will occur automatically, and HHAeXchange will handle all necessary updates.
HHAeXchange is sending emails to providers from customerexperience@hhaexchange.com in the coming weeks announcing the redesigned system. The email includes helpful resources to support a smooth transition. Contact HHAX using the HHAX Client Support Portal if you have questions about the redesign. (3/6/25)
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:
Minnesota Health Care Programs (MHCP) is changing the prior authorization requirements for the following lower limb prosthetics (HCPCS) from “always required” to “sometimes required” effective March 1, 2025:
Above knee, molded socket, open end, SACH foot, endoskeletal system, single axis knee (L5321)
Test socket prosthetics additions (L5618 to L5628)
Various prosthetic sockets (L5629 to L5653)
Socket inserts L5654 to L5699 (L5654 to L5699)
Protective covers (L5704 to L5707)
Exoskeletal knee-shin system additions (L5710 to L5780)
Vacuum pumps (L5781 to L5783)
Exoskeletal prosthetic additions (L5785 to L5795)
Most endoskeletal knee or hip system additions (L5810 to L5855, L5910 to L5926, L5940 to L5960, L5962 to L5966)
Most ankle and/or foot prosthetic additions (L5968, L5970 to L5972, L5974 to L5986, L5988, L5990)
Authorization will be required if these codes are recreational devices or exceed MHCP quantity limits. These codes allow one per device, except test sockets (L5618 to L5628) and socket inserts (L5654 to L5699), which allow two per device. Use modifier U1 for bathing devices and modifier U2 for recreational devices. Authorization is not required for member’s initial devices for everyday use or for bathing or showering. Bathing devices only require authorization if they are the member’s third device. Recreational devices, regardless of the individual HCPCS code, always require authorization. Subsequent new devices for any purpose require authorization.
School-based mental health and substance use disorder professionals are invited to explore topics related to effective care for youth experiencing a behavioral health crisis in this webinar-based training series. The course content has been revised to incorporate attendee feedback, with a focus on post-pandemic behavioral health challenges. The Minnesota Department of Human Services has partnered with the Training Institute at People Incorporated to provide live trainings throughout 2025 and offer recorded versions for later viewing.
The Conducting Reimbursable Behavioral Health Services in Schools webinar is scheduled from 3:30 – 5 p.m. on April 2, 2025. In this webinar, you will gain a comprehensive understanding of scope of practice, therapeutic interventions and skills required for effective billing practices, ensuring compliance and accuracy in documentation so that schools can be properly reimbursed for Individualized Education Programs behavioral health services. Go to the Conducting Reimbursable Behavioral Health Services in Schools webpage to review the webinar description and to register. (pub. 3/6/25)
MHCP offers free resources and MN–ITS training for enrolled MHCP providers who bill for recuperative care. Providers must be enrolled as a recuperative care facility or providing recuperative care services to attend the training.
Minnesota Department of Human Services and its partners have developed a new training video about Minnesota Rules, 9544, commonly known as the Positive Supports Rule or the rule on positive support strategies and restrictive interventions. The 37-minute training video is optional and is intended for all service providers licensed under Minnesota Statutes, 245A, except:
Minnesota Department of Human Services (DHS) will add the following recommended components of care to the Minnesota C&TC Schedule of Age-Related Screening Standards (DHS-3379) effective Oct. 1, 2025:
Syphilis screening at least once for young adults 18 years and older, and
Suicide risk screening beginning at age 12 years
The American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care Bright Futures Periodicity Schedule, U.S Preventive Services Task Force, Centers for Disease Control and Prevention, and the Minnesota Department of Health (MDH) recommend these updates. You are strongly encouraged to complete the recommended components as part of a C&TC visit.
Licensed behavior analysts (LBAs) can enroll as a qualified supervising professional (QSP) for Early Intensive Developmental and Behavioral Intervention (EIDBI) services effective Jan. 1, 2025. This update is intended to expand access to EIDBI services by allowing LBAs to oversee treatment for individuals with autism spectrum disorder and related conditions.
LBAs will be responsible as QSPs for developing and monitoring comprehensive treatment plans, supervising applied behavior analysis services, and ensuring high-quality, individualized care for members receiving EIDBI services. This update aligns with Minnesota’s commitment to increasing EIDBI provider capacity and improving access to early intervention services for children and families.
Review the EIDBI Provider Enrollment Criteria and Forms section of the Minnesota Health Care Programs Provider Manual for information about enrollment requirements and the application process. Review the QSP qualifications, roles and responsibilities section of the EIDBI policy manual for information about QSP qualifications and responsibilities (pub. 2/14/25)
With the MinnesotaCare expansion in effect as of January 1 (for more information, refer to DHS Bulletin 24-21-10 and the MinnesotaCare coverage expansion message published Nov. 19, 2024), new enrollees are now receiving MinnesotaCare coverage. Make sure to follow the correct steps to check eligibility. Some MinnesotaCare enrollees will be on fee-for-service rather than managed care plans, and do not have managed care ID cards.
Minnesota Health Care Programs (MHCP) covers the administration of the RSV vaccine ABRYSVO (CPT code 90678) for pregnant people effective Aug. 21, 2023.
Before administering the RSV vaccine ABRYSVO, providers need to verify the pregnant member’s eligibility for major program and eligibility type by using the eligibility verification request feature in MN–ITS. The pregnant member must be eligible for one of the following listed major programs and one of the following listed eligibility types:
Major programs: EH, IM, MA, NM, KK or LL
Eligibility types: PC, PX, 2P, 2X, P1 or P2
Members must report any updated information to their county of residence.
Providers should refer to the following for billing information:
For members 18 years old and younger: Billing for Child Vaccines in the Immunizations and Vaccinations section of the MHCP Provider Manual
Additionally, we reprocessed claims back to dates of service beginning Aug. 21, 2023. Reprocessed claims appeared on remittance advices for Dec. 3, 2024.
Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 2/12/25)
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. The trainings are scheduled for the following dates:
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)
The Minnesota Department of Human Services has a new online form for the Local County or Tribal Agency Monthly Transportation Report (DHS-8214). Lead agency providers should know the following:
Updating of records and bookmarks is critical: Providers should update records and bookmarks with the new link. The previous online form link will be unavailable soon.
