Provider Manual
Provider Manual
Effective September 01, 2011, Legislation allows MHCP to begin enrolling individual Dental Therapists (DT) to provide oral health services for MHCP recipients as specified within their scope and collaborative management agreement.
All DTs providing services for MHCP recipients must enroll and be identified as the treating provider on claims.
DTs providing services to enrollees in a managed care organization (MCO) must contact the MCO directly for enrollment requirements and coverage policy.
Services are primarily provided to low-income, uninsured and underserved recipients or in dental health professional shortage areas. These settings may include assisted living facilities, federally qualified health centers (FQHC), rural health centers (RHC), community health clinics (CHC) or Indian health services (IHS). DTs may practice in settings separate from the dentist under the CMA with a licensed MN Dentist who provides general supervision for services listed in MS150A.105 Subd. 4c and under indirect supervision for services listed in MS 150A.105 Subd. 4d.
The DT:
MHCP requires DTs to:
DTs must obtain an individual NPI through the National Plan and Provider Enumeration System (NPPES).
DTs must complete, sign, and fax the following forms and related documents to MHCP Provider Enrollment at (651) 431-7462:
MHCP Provider Enrollment will notify each applicant within 30 days of receiving the signed and completed application, agreement, and Collaborative Management Agreement of their enrollment status.
DTs also practicing as dental hygienists under limited authorization must also complete the enrollment process that is identified at Limited Authorization Dental Hygienists.
A DT certified by the Minnesota Board of Dentistry may perform the services and procedures within their scope of practice as identified in MS 150A.105 Subd. 4c &d and as specified in their written CMA.
Services not designated in the CMA.
The DT is prohibited from providing, dispensing, or administering a narcotic drug.
Bill all services completed using the following:
DT services must be billed by an eligible MHCP enrolled group provider using the individual DT NPI as the rendering provider to receive payment.
Reimbursement for services provided by DTs will be made at the rate of:
MS 256B.0625 Subd 59 Services provided by advanced dental therapists and dental therapists
MS 150A.10, Subd. 1a Limited Authorization for Dental Hygienists
MS 150A.105 Dental Therapist
MS 150A.105 Subd. 4c & d Dental Therapist allowed dental services
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