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Explanation of Findings

Revised: 06-28-2011

  • Overview
  • Eligible Provider
  • Eligible Recipients
  • Covered Services
  • Non-covered Services
  • Billing
  • Legal References

  • Overview

    Explanation of findings" means the explanation of a client's diagnostic assessment, psychological testing, treatment program, and consultation with culturally informed mental health consultants as required under parts 9520.0900 to 9520.0926, or other accumulated data and recommendations to the client, client's family, primary caregiver, or other responsible persons.

    The purpose of explanation of findings is to discuss the results of the diagnostic assessment, psychological tests, and other accumulated data and make recommendations in regard to the recipient’s treatment plan.

    Eligible Providers

    All Mental Health Professionals
    All Mental Health Practitioners working as clinical trainees under clinical supervision of mental health professional and authorized to provide psychotherapy and conduct diagnostic assessments.

    Eligible Recipients

    All MHCP Recipients

    Covered Services

    Explanation of findings is provided to the client, client's family, and caregivers, or to other providers to help them understand the results of the testing or diagnostic assessment, better understand the client's illness, and provide professional insight needed to carry out a plan of treatment. An explanation of findings is not paid separately when the results of psychological testing or a diagnostic assessment are explained to the client or the client's representative as part of the psychological testing or a diagnostic assessment.

    Explanation of findings is a face-to-face meeting between the mental health professional or mental health practitioner working as a clinical trainee and the recipient’s:

  • • Family
  • • Primary caregiver
  • • Other responsible persons such as:
  • • Case manager
  • • Child protection worker
  • • Community corrections agency
  • • Guardian
  • • Health care provider
  • • Local education agency representative
  • • Qualified developmental disabilities professional (QDDP)
  • • School
  • • Vulnerable adult worker
  • Non-Covered Services

    Explanation of findings services do not include:

  • • Providing clinical direction of employees or students who provide mental health services under the clinical supervision of the mental health professional conducting the explanation of findings
  • • Sharing information at regularly scheduled interagency coordination of care meetings where recipient care is discussed
  • • Not paid separately when the results of the diagnostic assessment or psychological testing are explained as part of those services
  • Authorization

    If services are medically necessary beyond the calendar year thresholds submit an authorization request (DHS-4695). Authorization is required to exceed 2 sessions per calendar year. Maximum of 4 sessions per calendar year.

    Billing

  • • Bill an explanation of findings using MN–ITS 837P
  • • Add appropriate modifier when mental health practitioner working as a clinical trainee renders service
  • Proc Code

    Mod

    Brief Description

    Unit

    Limitation

    90887

     

    Explanation of Findings

    1 Session

    Up to two sessions per calendar year without authorization. Maximum of four sessions per calendar year.

    90887

    HN

    Explanation of Findings conducted by clinical trainee

    1 Session

    Teaching hospitals may enter the GC modifier for services performed under the direction of a supervising physician.

    Legal References

    Minnesota Rule 9505.0370, subpart 13
    Minnesota Rule 9505.0372, subpart 5

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    Updated: 7/21/11 2:43 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 7/21/11 2:43 PM