MHCP Provider News

February 21, 2017


  • Transition to NETStudy 2.0: All entities that currently have a Department of Human Services (DHS) NETStudy account access to the original NETStudy portal will be transitioned to “view only” access effective February 28, 2017. This means all background study requests for affected providers must be submitted through NETStudy 2.0 beginning March 1, 2017. You will find additional information under the section titled “NETStudy 2.0 Transition Status-Dec. 30, 2016” on the Background study web page.
  • Language interpreter services: Authorization is now required for interpreter services (T1013) if more than 8 units (1 unit = 15 minutes) per date of service are needed. Submit the authorization request to KEPRO through the MHCP authorization process. For more details, go to the MHCP Provider Manual Access Services section.
  • Expanded MinnesotaCare Eligibility: Beginning January 1, 2017, MinnesotaCare coverage will be extended to some uninsured Minnesotans who were not previously eligible. You may now verify eligibility for these members through MN–ITS or the eligibility verification system (EVS). See the MinnesotaCare Expanded Eligibility for Certain Populations web page for information about authorizations and billing for services you provide for people who qualify for this coverage.
  • • See grants and requests for proposal (RFPs) for current grants available or RFPs in which you may be interested.
  • Review recent Provider Updates

  • Point of Sale Diabetic Testing Supply Program (PRX-17-02)
  • Training and VideoPresence Opportunities

    Refer to the Provider Training page for information about new and ongoing training or to the list below for details on additional training sessions on special topics.

    MN–ITS

    Batch submitters receiving errors: Some batch submitters are receiving errors when trying to upload batch files to DHS. Take the following steps to alleviate these issues:

    For Internet Explorer (IE):

  • • Press Ctrl + Shift + Delete
  • • Uncheck “Preserve Favorites website data”
  • • Check the “Temporary Internet files and website files” and “Cookies and website data” boxes
  • • Click the “Delete” button
  • • Close all open IE browser sessions. Reopen the browser and attempt the upload again.
  • For other browsers:

  • • Press Ctrl + Shift + Delete
  • • Select “Cookies” and “Cache” options
  • • Delete or clear browsing data
  • • Close all open browser sessions. Reopen the browser and attempt the upload again.
  • Announcements and availability: Watch the 5010/D.0 Announcements page for information about MN–ITS functionality, technical information, scheduled downtimes and other notifications.

    Early Intensive Developmental and Behavioral Intervention (EIDBI)

    CTSS training curriculum deadline: Early Intensive Developmental and Behavioral Intervention (EIDBI) providers who are also providing Children’s Therapeutic Services and Supports (CTSS) may substitute their existing CTSS training curriculum for the required Autism 101 training. The Autism 101 training is required for all enrolled EIDBI Level III providers. EIDBI provider agencies may submit the CTSS training curriculum to DHS for approval if it includes all the training components covered in the Autism 101 training. We have extended the date to submit training for approval to June 30, 2018. For more information email ASD.DHS@state.mn.us.

    EIDBI advisory group: DHS has reviewed all applications and finalized all appointments to the EIDBI Advisory Group. We will notify all applicants of their status by the end of February 2017. Selected candidates will receive an invitation to the first meeting that is scheduled for March 31, 2017, from 10 a.m. to noon. Email questions to ASD.DHS@state.mn.us.

    Hospitals

    Inpatient Hospitals

    Reprocessing inpatient claims that paid at an interim payment rate: We will reprocess fee-for-service (FFS) prospective payment system (PPS) inpatient claims for hospital services that were paid at interim rates while the new APR-DRG rates were being programmed. Reprocessed claims will pay at the new APR-DRG rate and will be on the February 21 and March 7 remittance advice (RA).

    Phase One – February 21, 2017, RA will include:

  • • Discharges between November 1, 2014, and June 30, 2015
  • • Discharges between July 1, 2015, and September 30, 2015
  • • Discharges between October 1, 2015, and December 31, 2015
  • All three spans will be on the same RA but with different Julian dates so that you can distinguish between each of the three time periods.

    Phase Two – March 7, 2017, RA will include discharges between January 1, 2016, and January 7, 2017.

    Repayment options
    The MHCP default method of recoupment is to fully or partially reduce all payments until the total amount owed has been repaid. If you prefer, you may set up a repayment plan. Under the repayment plan option, you can ask that a fixed dollar amount be withheld from each RA until you have repaid the entire amount you owe. A repayment plan ensures that you receive at least some payment on each RA instead of receiving a zero payment.

    Refer to the Payment Methodology for Inpatient Hospitals web page. If you have questions about the repayment plan option, call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411.

    Outpatient Hospitals

    Off-campus provider-based hospital department services: Beginning January 1, 2017, off-campus provider-based hospital department services must identify nonexcepted service lines on their claims using modifier PN (nonexcepted off-campus service). MHCP is working on the system change to price service lines modified with PN using the physician fee schedule following CMS guidelines in MLN Matters 9930. We will notify providers when the programming is completed and will retroactively reprocess claims.

    Observation and extended assessment and management (E&M) composite: MHCP has completed the programing for the Ambulatory Payment Classification (APC) observation procedure code G0438 when performed with E&M services. Effective for dates of service on or after July 1, 2015, E&M services will be priced using a composite rate when there are eight or more hours of observation. Refer to CMS MLN Matters MM8653 and MM9486. MHCP will retroactively reprocess claims and notify providers on the expected remittance date.

    Off-campus provider-based hospital department services: Beginning January 1, 2017, off-campus provider-based hospital department services must identify nonexcepted service lines on their claims using modifier PN (nonexcepted off-campus service). MHCP is working on the system change to price service lines modified with PN using the physician fee schedule following CMS guidelines in MLN Matters 9930. We will notify providers when the programming is completed and will reprocess claims retroactively.

    Ambulatory Payment Classification (APC) Payment Status Indicators (PSI) Q1 or Q2: MHCP is programming the Centers for Medicare & Medicaid Services (CMS) PSI Q1 or Q2 packaging changes that are effective Jan. 1, 2017. Outpatient APC claims with PSI Q1 or Q2 are subject to APC packaging methodology for services on the same claim regardless of the date of service. We will retroactively reprocess claims and will notify providers when the changes are complete. Refer to CMS’s MLN Matters MM9930 for further guidance.

    Mental Health

    Intensive Treatment in Foster Care Training Sessions: Providers who are interested in providing intensive treatment in foster care need to be certified and attend one of the “Intensive Treatment in Foster Care (ITFC) Applicant Provider Information Sessions.“ You can read more in the bulletin Children’s Mental Health Announces New Service: Intensive Treatment in Foster Care.

    Sign up for the training though TrainLink. Session dates are March 28, May 16, August 22 and November 14, 2017, from 9:00 a.m.–12:00 p.m.

    Billing changes for family psychotherapy: Effective January 1, 2017, CPT codes 90846 (family psychotherapy without patient present) and 90847 (family psychotherapy with patient present) have changed to a time based code. Review CPT code guidelines for additional information. The calendar year limits for these services remain the same. Authorization is required if a person needs more than the yearly threshold.

    Physicians and Clinics

    Off-campus provider-based hospital department services: Beginning Jan. 1, 2017, off-campus provider-based hospital department services must identify nonexcepted service lines on their claims using modifier PN (nonexcepted off-campus service). MHCP is working on the necessary system change to price service lines modified with PN using the MHCP fee schedule. We will notify providers when the programming is completed and will retroactively reprocess claims. Refer to CMS MLN Matters MM9930 (PDF) for further guidance.

    Waiver and Alternative Care Programs

    Night supervision services approved: Night supervision services are now available under the Community Access for Disability Inclusion (CADI) waiver. CMS recently approved this change. For more information, see DSD eList – Night supervision services now available under CADI Waiver.

    Training and VideoPresence Opportunities

    Information about most new and ongoing training is on the Provider Training page. Any information listed in this section is for additional training sessions on special topics.

    Grants and RFPs

    See the Grants and requests for proposals web page for more information.

    Related Links

    Visit our Provider website for more comprehensive information, including these pages:

  • Latest Manual Revisions
  • • Previously published Provider News items
  • Provider Updates (we also place newly published Provider Updates in your MN–ITS Mailbox, as appropriate)
  • This page includes news and resources for providers enrolled to serve Minnesota Health Care Programs (MHCP) recipients. Get notices of Provider News through our free Provider Email Lists.

    If you have questions about this information, call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411.

    Sign up to receive Provider Updates and other MHCP notices in your email account.

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