MHCP Provider News

January 9, 2017

  • Billing change for some Medica enrollees: Beginning May 1, 2017, Medica will no longer provide health care coverage for families and children on Medical Assistance or MinnesotaCare. As a result of this change, new benefits that MHCP covers effective January 1, 2017, will be available to some Medica members only through fee-for-service (FFS). Refer to the web page for complete information about these Medica claims. You will need to submit a copy of the web page as a claim attachment when billing for these services.
  • Provider application fees change for 2017: The provider enrollment application fees increase to $560 on January 1, 2017. The increase applies to screening and application fees paid on or after January 1, 2017, regardless of when the application is submitted. Refer to the Provider Screening Requirements section of the MHCP Provider Manual for more information.
  • • 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)
  • Requirements of enteral nutrition claims submission (PRX-17-01)
  • Special Needs BasicCare (SNBC) Policy Change (MHP-16-04)
  • 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 mailbox changes: MN–ITS mailbox functions will be unavailable beginning at 11:59 p.m. on January 20, 2017, for technical maintenance. We expect the mailboxes to be available by 6 a.m. Monday, January 23. No mailbox applications will be available during this time. During this time, MHCP will remove data from MN–ITS mailbox folders. Other applications within MN–ITS, including direct data entry claim and eligibility transactions, will not be affected by this work and will remain available.

    When mailbox access is restored, items in the following folders will display data received within at least the last 30 days (any other files that were previously sent to you will no longer be available): 835_X12, 835_PDF, 835C, 835E, 834, 820, IHL, SAL, PAL, PRVLTR, CML.

    You must remove all of the items in your mailboxes that you want to keep by 11:59 p.m. on January 20.

    Going forward, we will periodically delete old data following the mailbox retention schedule. We expect these actions will improve MN-ITS functionality by reducing downtime and increasing processing speed.

    Batch file submitters: You will not be able to submit batch files through MN–ITS during the maintenance. You will be able to submit files through Secure FTP, but you will not receive any transaction responses until after the maintenance is complete.

    Please call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411 if you have any questions.

    New address for SFTP service: You may need to change your SFTP connection before February 1, 2017. DHS is changing to a new address for our SFTP service. If you are currently using this service, you are connecting to it through one of the following addresses:

  • port 2222 – if you are using this address, you do not need to make any changes to your SFTP client connection. You should not experience any interruption in service.
  • port 2222 – if you are using this address, we recommend that you change this to port 2222 by February 1, 2017. If your client software does not support connecting through a host name entry, change the NAT address you are using to port 2222.
  • You may use either of these addresses through January 31, 2017.

    Announcements and availability: Watch the 5010/D.0 Announcements page for information about MN–ITS functionality, technical information, scheduled downtimes and other notifications.

    Chemical Dependency

    Behavioral Health Planning Council Applications: The Mental Health and Alcohol and Drug Abuse Divisions are renewing applications for the Behavioral Health Planning Council. We will accept applications for council membership through January 16, 2017. Refer to the Behavioral Health Planning Council Renewing Applications E-Memo for more information.

    Survey of Continuum software potential users: The Alcohol and Drug Abuse Division (ADAD) is applying for a section 1115 demonstration project with the Centers for Medicare & Medicaid Services (CMS) to support the transformation of the substance use disorder care delivery system in Minnesota.

    We need to provide information on how many assessors, or “users,” will need access to the American Society of Addiction Medicine (ASAM) Continuum software. Please respond to this question through the Survey of Continuum Potential Users by January 12, 2017.

    Child and Teen Checkups (C&TC)

    C&TC CPT Code Change for Maternal Depression Screening: CPT code 99420 with a UC modifier that is currently used for maternal depression screening will be discontinued effective January 1, 2017. The new CPT code for maternal depression screening will be 96161. See the Child and Teen Checkups (C&TC) section of the MHCP Provider Manual.

    Community Emergency Medical Technician (CEMT)

    A new provider type, community emergency medical technician (CEMT), begins January 1, 2017. CEMTs will help to meet the health care needs of MHCP members within the first 24 to 48 hours of being discharged from a hospital or nursing home or for safe home checks due to multiple calls for assistance at the recipient’s home.

    To learn more about CEMT services go to the new Community Emergency Medical Technician (CEMT) Services section of the MHCP Provider Manual


    Billing teledentistry services: MHCP enrolled dental providers who self-attest that they meet all of the conditions of the MHCP telemedicine policy by completing the Provider Assurance Statement for Telemedicine (DHS-6806) (PDF) can now submit claims for teledentistry services using the CDT code that describes the services rendered. Use place of service (POS) 02 and enter teledentistry in the text field for the dates of service on or after January 1, 2017. For dates of services you provided between January 1, 2016, and December 31, 2016, enter only teledentistry in the text field; do not include the POS. For more information, see teledentistry in the MHCP Provider Manual.

    Critical access dental payments: Effective January 1, 2017, managed care organizations (MCO) critical access dental payments (CAD) will be included in the capitation paid to all MCOs except Medica. Each MCO will calculate and determine how the CAD payments are made to designated providers for MA and MinnesotaCare recipients. Contact the MCO with whom you have a provider agreement for any questions or concerns.

    For all Medica providers, the payments for the first four months of 2017 will be paid directly from Medica to each participating providers.

    Early Intensive Developmental and Behavioral Intervention (EIDBI)

    CMDE and ITP updates and service agreement exception: DHS is beginning to send comprehensive multidisciplinary evaluation (CMDE) and individual treatment plan (ITP) update reminder letters 60 days before the update is due to allow time for you to complete the assessment. You must submit the updated documents to the state medical review agent at least 30 days before the end date of the current service agreement for them to complete the authorization process.

    Each recipient must have an approved service agreement through the state medical review agent before receiving EIDBI services. However, the review agent will make a temporary exception for providers submitting the CMDE or the ITP progress monitoring update between now and February 1, 2017. This exception will cover a gap of no more than 30 days between the end date of the previous service agreement and the approval date of the new or continued service agreement. This exception will be in effect only until February 1, 2017, and does not apply to the initial authorization of EIDBI services.

    After February 1, 2017, you must ensure that you have submitted all documentation and the state medical review agent has approved it before the current service agreement expires to avoid any lapse in services.

    Group Residential Housing (GRH) Supplemental Services

    Billing through MHCP: The initial start date for Group Residential Housing (GRH) Supplemental Services (rate 2) providers to bill MHCP for services was projected for early 2017. This is now delayed until August 2017. Watch Provider News as it gets closer to the billing implementation date for more information. Also watch the Training for Group Residential Housing (GRH) Supplemental Services page for information and dates of training for MN–ITS billing.

    This change does not apply to GRH providers that receive only room and board (rate 1) payments, such as adult foster care. The way providers receive payment for room and board is not changing. For more detailed information on this change, refer to the Provider Update, Group Residential Housing (GRH) Supplemental Services.

    Hearing Aid Providers

    The 2016 Hearing Aid Contract (DHS-7274D) (PDF) was updated with the addition of four Phonak Roger 18 and 19 receivers.

    Mental Health

    Behavioral Health Planning Council Applications: The Mental Health and Alcohol and Drug Abuse Divisions are renewing applications for the Behavioral Health Planning Council. We will accept applications for council membership through January 16, 2017. Refer to the Behavioral Health Planning Council Renewing Applications E-Memo for more information.

    Billing changes for adult rehabilitative mental health services (ARMHS): Calendar year limits for the billable units for CPT code H0031, Functional Assessment (FA), and CPT code H0032, Individual Treatment Plan (ITP), changed on January 1, 2017. The FA and ITP are combined for the initial and the review and update units. An authorization is required if a person needs more than the yearly threshold.

    Dialectical behavior therapy system change requirements: System changes that were effective May 1, 2016, for dialectical behavior therapy (DBT) services require the following:

  • • You must bill with the certified DBT team as the pay-to provider
  • • The claim pay-to provider, treating provider, and provider submitting the authorization request must be DBT intensive outpatient program (IOP) certified
  • • All DBT services must be authorized
  • Minnesota Family Planning Program (MFPP)

    MFPP changes for January 2017: Several policy changes to the Minnesota Family Planning Program (MFPP) eligibility and coverage for members are effective January 1, 2017. Refer to the list of these changes on the MFPP provider web page. We will post an updated version of the MFPP Provider Training Guide as soon as possible; it may not currently reflect the January 1, 2017, changes.

    Nonemergency medical transportation (NEMT) will be a covered service for MFPP members for dates of service on or after January 1, 2017. Refer to the NEMT section of the MHCP Provider Manual for more information about covered NEMT services and billing requirements.

    We revised several questions in the MFPP Application (DHS-4740) (PDF) to reflect the policy changes. Use the new version of the application. The application is not fillable at this time. Print the application to complete it and then fax it to the number on the first page. If you have printed copies from DHS of the previous version of the application, you may still use them.

    Moving Home Minnesota

    Case management redesign workshop: DHS Aging and Adult Services and Disability Services divisions invite you to a free one-day case management redesign workshop on January 31, 2017. For more information, see the DSD eList announcement.


    Claim calculation process: MHCP updated the nonemergency medical transportation (NEMT) rural urban commuting area (RUCA) claim calculation process. We will now determine whether a RUCA payment applies to a claim based on the July 1, 2016, Medicare ambulance ZIP code file used for RUCA calculations. This is the ZIP code list and link we provided during the June 30, 2016, NEMT videoconference training. The ZIP code classifications on the file are:

  • • Blank = Urban
  • • R = Rural
  • • B = Super rural
  • We will reprocess previously paid claims using the updated ZIP code file. The reprocessed claims will be on your remittance advice on or after December 27, 2016. Transport reimbursement, including the RUCA add-on amounts, will be the lesser of the provider’s submitted charge or the calculated allowable amount.

    Beginning January 1, 2017, the ZIP code file will be updated on January 1 each year for use the entire calendar year. For a link to the file effective January 1 each year, go to CMS Ambulances Services Center. Under Important Links, click on “Zip Code to Carrier Locality File,” then open the Excel file and look for the “MN” ZIP code section.

    IRS mileage rate: The IRS business deduction rate for volunteer driver and licensed foster parent personal mileage reimbursements will be 53.5 cents per loaded mile for dates of service on and after January 1, 2017. The rate will apply for dates of service through December 31, 2017, unless the IRS makes a change before that date.

    Waiver and Alternative Care Programs

    Provider signature now required for Coordinated Services Support Plans (CSSPs): Lead agencies must now have each home and community-based services (HCBS) provider sign the recipient’s HCBS support plan. For more information, see DSD eList announcement on signature requirements for CSSPs.

    Revised HCBS transition plan sent to CMS: DHS submitted a new home and community-based services (HCBS) statewide transition plan (PDF) to the federal Centers for Medicare & Medicaid Services for approval on December 2, 2016. For more information, read the announcement DHS submits revised HCBS transition plan.

    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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