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Review the Day Training and Habilitation (DT&H) section of the Community Based Services manual (CBSM) for information about DT&H services including federal and state guidelines.
DT&H day services are provided on a scheduled basis for periods of less than 24 hours each day.
Providers eligible to provide, bill and receive payment from Minnesota Health Care Programs (MHCP) for providing DT&H day services must:
Counties must provide DT&H services and only provide these services through the Department of Human Services (DHS) licensed DT&H day service providers.
MHCP requires each DT&H satellite location to have its own NPI or UMPI number. To enroll to provide DT&H day services and transportation follow the instructions in the HCBS Waiver and Alternative Care (AC) Provider Enrollment section of the MHCP Provider manual.
Contact DHS Licensing at 651-431-6500 or the DHS Licensing web page for Home and Community-Based Services (HCBS) for People with Disabilities and Age 65 or Older – 245D for information on how to get a 245D license.
MHCP requires those who provide services to register their MN–ITS account.
DT&H day services are available to people who:
Counties must determine the need for DT&H day services according to requirements in Minnesota Statutes. Lead agencies must immediately contact DHS DSD Response Center at DSD.ResponseCenter@state.mn.us when their proposed actions seek to increase, grow or expand DT&H day services.
Verify program eligibility for each recipient, each month through the MHCP phone eligibility verification system (EVS) or MN–ITS before providing services.
For DT&H services identified in a CSSP, counties are responsible to:
County case managers (CM) are responsible for:
Use the codes in the following table to bill for services provided. DT&H transportation can be used only for DT&H services.
Services and procedure codes
Procedure Code and modifier
DT&H – Daily (6 hours or more)
DT&H – Partial Day (Less than 6 hours)
DT&H – 15 min
DT&H Transportation – Daily
When Medical Assistance (MA) funding covers DT&H day services for people who are MA eligible and reside in an ICF-DD or are MA eligible and receive home and community-based waiver services for persons with developmental disabilities or related conditions (DD waiver), then MA funding for DT&H day services must not pay for either of the following:
Do not use extended transportation to supplement the DT&H transportation rate. Minnesota statutes and the federal DD waiver plan prohibit additional payment for transportation when it is included in the established rate.
Maintain service records, fiscal records and supporting documentation identifying the items below:
In addition, the following requirements apply:
DHS requires two-party agreements to be completed between each ICF/DD and the DT&H day service provider that is providing residents with services. Parties need to complete these agreements only once unless there is a change in training and habilitation agencies.
Three-party agreements between the training and habilitation agency, ICF/DD, and the county are required annually. These agreements outline the responsibilities of each party and reflect the current approved MA reimbursement rates, service hours, days of service and operating months. Three-party agreements are necessary to comply with county contracting requirements found in statute and rule. However, CMS does not recognize them as evidence of compliance with 42 CFR 447.10 (e), which requires the ICF/DD to have a separate written agreement with each training and habilitation agency providing services to residents.
Federal regulations require that an ICF/DD whose residents receive licensed DT&H day services outside the facility must have a two-party agreement with the provider of those services.
The ICF/DD, the county in which it is located, and the DT&H vendor must sign a three-party agreement Day Training and Habilitation Service Agreement (DHS-2638) (PDF), which spells out the responsibilities of each party, along with the rates, days of service and operating months.
When MA funds are used to pay for DT&H day services for a person living in an ICF/DD, the county case manager:
The DT&H and ICF/DD may make any legal arrangement to secure authorized signatures on billing invoices. Each ICF/DD is responsible for ensuring that the DT&H provides the required services to its residents regardless of whether the ICF/DD has given the DT&H power of attorney to act on its behalf. As stated in the Two-Party Agreement section above, when ICF/DD personnel sign, they are accepting responsibility for the accuracy and legitimacy of the bills they authorize for submission to DHS. This means they are verifying the accuracy of the stated charges, days of service, and transportation provided for each recipient who is a resident of the ICF/DD. The two-party agreement also states that the DT&H accepts responsibility for the accuracy and legitimacy of bills it submits to the ICF/DD for signature.
Waiver services require approval from a case manager or service coordinator in the form of a completed service authorization or service agreement (SA). The SA allows the provider to bill MHCP and receive payment after the DT&H provides the services. Only services approved on the SA can be paid; however, the recipient must maintain both MA and waiver eligibility for the authorization to be valid. The case manager or service coordinator enters the SA into the DHS system (MMIS). The provider is responsible for ensuring the SA is accurate when they receive the authorization letter.
Each line item on the SA lists the following:
The Disability Waiver Rates Management System (DWRS) determines DT&H day services HCBS waiver rates according to Minnesota Statutes. After the lead agency conducts the needs assessment and community support plan to determine the recipient’s needs, the DWRS will be used to establish individual rates.
DT&H day services must meet a minimum of 195 available service days. Bill DT&H services to MHCP that were provided to a resident of an ICF/DD only if DT&H day services are not included in the ICF/DD DHS approved rate. Three ICF/DD MA payment rates exist for providers of DT&H day services. The ICF/DD MA payment rates are:
MA will directly reimburse vendors of DT&H day services provided to residents of an ICF/DD when payment is authorized by the ICF/DD according to Minnesota Statutes.
DT&H providers are responsible for arranging, providing, and paying for transportation of a recipient to and from the recipient’s residence and the DT&H service site. DT&H providers can subcontract with special transportation providers if those providers accept the DT&H transportation rate as payment in full. Trips to and from DT&H service sites are not eligible for payment as special transportation. Counties and county social workers or case managers may not authorize MHCP payment for special transportation to or from DT&H day services.
Exception for Special Transportation
The only circumstance under which MHCP special transportation may be billed for a trip to or from a DT&H site for a recipient receiving DT&H day services at that site is when a recipient is being transported from the DT&H site to a site providing MHCP-covered services that are not DT&H services. The special transportation provider must bill for this transportation and may not include billing for special transportation between the recipient’s residence and the DT&H site.
Minnesota Rules govern the authorization of special needs rate exceptions for very dependent people with special needs residing in an ICF/DD. The lead agency sends the request for a SA to DHS. DHS sends the approval letter through MN–ITS to the provider. Review the 186 Special Needs Funding section of the CBSM for more information.
The approved service agreement indicates the following procedure codes and rates:
The DWRS determines the DT&H day services rates according to Minnesota Statutes, including any DT&H day services rate exceptions.
The Disability Services Division (DSD) at DHS grants final approval and will override the rate file on the SA for a person who receives the special needs rate exception. Counties do not have the ability to override the rate file in the MMIS system. Lead agencies can complete and submit the Disability Waiver Rates System Exception Request Application (DHS-5820) (PDF).
The school district must pay for DT&H day services provided to recipients 21 years old or under unless the Individual Education Plan team determines that the recipient has met educational goals and will graduate. For DHS to pay for services provided to a recipient 21 years old or under, the county case manager must send the following information to the DHS DT&H policy person before the provider bills:
If the recipient resides in an ICF/DD, bill the DT&H day services with a copy of the DHS letter as an attachment. Review Electronic Claim Attachments.
Bill DT&H day services electronically using the SA number if the recipient is on a DD waiver. Follow these guidelines to submit claims for full day, partial day and transportation:
Additional Billing Instructions for Recipients in an ICF/DD
Use the codes in the following table to bill for services provided to a recipient in an ICF/DD. These services do not require a SA.
Procedure codes for recipients in an ICF/DD
Full date rate (6 or more hours)
Partial day rate (less than 6 hours)
T2020 with modifier U5
Guidelines for Full Day, Partial Day and Transportation
Waiver SAs must include separate line items for each provider if the service is rendered on the same day by more than one agency. More than one provider may bill for approved partial day services provided on the same day. Only one provider may bill for daily service codes per day. If there is more than one provider of service, services need to be coordinated and the providers must bill only the actual dates of service.
Minnesota Statutes 252.28 (Commissioner of Human Services; Duties)
Minnesota Statutes 256B.092 (Services for Persons with Developmental Disabilities)
Minnesota Statutes 252.41 (Definitions)
Minnesota Statutes 252.42 (Service Principles)
Minnesota Statutes 252.43 (Commissioner’s Duties)
Minnesota Statutes 252.44 (County Board Responsibilities)
Minnesota Statutes 252.45 (Vendor’s Duties)
Minnesota Statutes 252.46 (Payment Rates)
Minnesota Statutes 256B.501 (Rates for Community-Based Services for Disabled)
Minnesota Statutes 252.282 (ICF/DD Local System Needs Planning)
Minnesota Statutes 144 (Department of Health)
Minnesota Statutes 245D (Home and Community-Based Services Standards)
Minnesota Statutes 256B.5015 (Pass-through of Other Services Cost)
Minnesota Rules 9525.0036 (Determination of Need)
Minnesota Rules 9525.1240 (Day Training and Habilitation Agreement)
Minnesota Rules 9525.1250 (Reimbursable Services)
Minnesota Rules 9505.2160 (Scope and Applicability)
Minnesota Rules 9505.2245 (Appeal of Department Action)
42 CFR 483.410(d)
42 CFR 483.440
42 CFR 447.10(e)
CPT codes, descriptions and other data only are copyright 2002 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.Report/Rate this page