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Mental Health Services

Revised: 06-22-2018

  • Overview
  • Eligible Providers
  • Eligible Recipients
  • Covered Services
  • Units (bases for measurement)
  • Outcome Measures Reporting
  • Noncovered Services
  • Legal References
  • Overview

    Minnesota’s publicly provided mental health system, as reflected in the Minnesota Comprehensive Mental Health Acts, is DHS-supervised and county-administered. Counties act as the local mental health authority. Review Mental Health Provider Requirements for information about criteria to be an eligible Minnesota Health Care Program (MHCP) mental health provider.

    Components of Service Delivery

    Mental health service delivery is composed of six key components:

  • Diagnostic assessment
  • Functional assessment (Adult)
  • Level of care assessment (LOCUS – Adult Mental Health)
  • • Individual treatment plan (ITP)
  • • Service delivery
  • • Reassessment
  • The following diagram shows the mental health service-delivery process and the relationship between the components.

    DHS image

    Eligible Providers

    Mental health providers include agencies and individuals (professionals and practitioners). Each mental health agency must have at least one mental health professional on staff. Providers may be eligible to enroll as MHCP providers (mental health professionals) or may be eligible to provide services but not eligible to enroll as MHCP providers (mental health practitioners, CTSS mental health behavioral aide).

    When qualified state staff provides adult mental health services, they are considered part of the certified local provider entity and their services may be billed according to typical billing practices as appropriate to the specific service.

    Mental Health Agencies

    The following agencies may enroll with MHCP:

  • • Adult day treatment
  • • Billing entity for mental health
  • • County-contracted mental health rehabilitation service
  • • Community mental health center (CMHC)
  • • County human service agency
  • • Indian Health Service (IHS) or 638 facilities
  • • Outpatient hospital
  • • Physician-directed clinic
  • • School district
  • Mental Health Professionals

    The following mental health professionals may enroll with MHCP:

  • Clinical nurse specialist (CNS)
  • Licensed independent clinical social worker (LICSW)
  • Licensed marriage and family therapist (LMFT)
  • Licensed professional clinical counselor (LPCC)
  • Licensed psychologist (LP)
  • Mental health rehabilitative professional
  • Psychiatric nurse practitioner (NP)
  • Psychiatry or an osteopathic physician
  • • Tribal certified professionals
  • Mental Health Providers

    The following are not eligible to enroll as an MHCP provider:

  • Adult mental health rehabilitation worker
  • Certified peer specialist
  • Mental health practitioner clinical trainee
  • Mental health behavioral aide (CTSS only)
  • Mental health practitioner
  • Mental health case manager or case manager associate
  • General Clinical Supervision Requirements

    Clinical supervision is the process of control and direction of a recipient’s mental health services by which an MHCP-enrolled mental health professional accepts full professional responsibility for the supervisee’s actions and decisions, instructs the supervisee in the supervisee’s work, and oversees or directs the work of the supervisee.

    MHCP has more than one mental health clinical supervision standard:

  • • Refer to Clinical Supervision of Outpatient Mental Health Services for requirements on supervision of diagnostic assessment, psychotherapy and explanation of findings
  • • Refer to the Specialty Specific Mental Health Supervision Requirements chart and specific covered services sections for other supervision requirements
  • Medicare Enrollment Denials

    When Medicare denies enrollment as a Medicare provider, the following MHCP providers must submit the denial letter from Medicare to MHCP Provider Enrollment:

  • • LICSW
  • • LP
  • • NP or CNS with mental health specialty
  • Submit the Mental Health Professional Applicant Assurance Statement – Medicare Enrollment Denial (DHS-3864) (PDF) every 18 months after the date of initial Medicare denial. Inform MHCP Provider Enrollment immediately when Medicare approves enrollment.

    Right to Appeal Denial of Certification or County Contract

    Providers required to be certified by or contracted with a county as part of the criteria to become an authorized provider of mental health services may appeal a county refusal to grant the necessary contract or certification. A recipient may initiate an appeal on behalf of a provider-denied certification. Either recipients or providers may submit a request for a review of the county decision to the Adult or Children’s Mental Health Division by either fax or mail to the following:

    Fax (adult):

    651-431-7418 (Attn: Mental Health Appeal Review)

    Fax (children):

    651-431-2321 (Attn: Mental Health Appeal Review)


    DHS Mental Health Division – Appeal Review
    P.O. Box 64981
    444 Lafayette Rd
    St Paul, MN 55164-0981

    Eligible Recipients

    Recipients eligible to receive mental health services must be eligible for MHCP.

    A resident of an Institution for Mental Disease (IMD) is eligible to receive MA services only if the recipient is receiving inpatient psychiatric care in a Joint Commission on Accreditation of Healthcare Organizations (JCAHO)-accredited psychiatric facility and meets one of the following criteria:

  • • Is under 21 years old
  • • Is 21 years old, but less than 22 years old and has been receiving inpatient psychiatric care in the IMD continuously since the resident’s 21st birthday
  • • Is at least 65 years old
  • Recipients 21 years old and older but under 65 years old and residing in an IMD must receive their mental health services through the IMD. A recipient discharged from the IMD may become eligible for mental health services if he or she meets eligibility criteria. If discharged within 180 days, the recipient is eligible to receive case management services through relocation service coordination (RSC). Contact the managed care organization if the recipient is receiving services through the managed care organization.

    Most mental health services have recipient eligibility requirements that require the recipient to meet the criteria in one or more of the following definitions:

  • Child with emotional disturbance: A child with an organic disorder of the brain, or a clinically significant disorder of thought, mood, perception, orientation, memory or behavior that meets both of the following:
  • • Is detailed in a diagnostic code list published by the commissioner
  • • Seriously limits a child’s capacity to function in primary aspects of daily living, such as personal relations, living arrangements, work, school and recreation
  • (For children under age 5 years old, trained professionals can refer to the DC:0-3 Code List)

    Emotional disturbance is a general term and intended to reflect all categories of disorder described in the ICD code ranges in the diagnostic code list, as usually first evident in childhood or adolescence.

  • Mental Illness: An organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory or behavior that meets both of the following:
  • • Is detailed in a diagnostic code list published by the commissioner
  • • Seriously limits a person’s capacity to function in primary aspects of daily living such as personal relations, living arrangements, work and recreation
  • Serious and persistent mental illness (SPMI): A condition with a diagnosis of mental illness that meets at least one of the following:
  • • The recipient had two or more episodes of inpatient care for mental illness within the past 24 months
  • • The recipient had continuous psychiatric hospitalization or residential treatment exceeding six months’ duration within the past 12 months
  • • The recipient has been treated by a crisis team two or more times within the past 24 months
  • • The recipient has a diagnosis of schizophrenia, bipolar disorder, major depression or borderline personality disorder; evidences a significant impairment in functioning; and has a written opinion from a mental health professional stating he or she is likely to have future episodes requiring inpatient or residential treatment unless community support program services are provided
  • • The recipient has, in the last three years, been committed by a court as a mentally ill person under Minnesota statutes, or the adult’s commitment as a mentally ill person has been stayed or continued
  • • The recipient was eligible under one of the above criteria, but the specified time period has expired
  • • The recipient was eligible as a child with severe emotional disturbance, and the recipient has a written opinion from a mental health professional, in the last three years, stating that he or she is reasonably likely to have future episodes requiring inpatient or residential treatment of a frequency described in the above criteria, unless ongoing case management or community support services are provided
  • Severe emotional disturbance (SED): SED is when a child with emotional disturbance meets one of the following criteria:
  • • Has been admitted to inpatient or residential treatment within the last three years or is at risk of being admitted
  • • Is a Minnesota resident and receiving inpatient or residential treatment for an emotional disturbance through the interstate compact
  • • Has been determined by a mental health professional to meet one of the following criteria:
  • • Has psychosis or clinical depression
  • • Is at risk of harming self or others as a result of emotional disturbance
  • • Has psychopathological symptoms as a result of being a victim of physical or sexual abuse or psychic trauma within the past year
  • • Has a significantly impaired home, school or community functioning lasting at least one year or presents a risk of lasting at least one year, as a result of emotional disturbance, as determined by a mental health professional
  • Refer to Relocation Services Coordination Targeted Case Management for more information.

    Recipients not eligible for mental health services are those eligible for one of the following programs:


    Alternative Care Program


    Minnesota Family Planning Program (MFPP)


    Qualified Medicare Beneficiary

    Covered Services

    Providers may deliver some mental health services by Telemedicine. Review the MHCP MH Code and Rates Chart.

    The following are covered mental health services (refer to the linked sections for additional service-specific information):

  • • Crisis Services
  • Adult Crisis Services
  • Metro Area Residents (DHS-4485) (PDF)
  • Greater Minnesota Residents (DHS-4484) (PDF)
  • Children’s Mental Health Crisis Response Services
  • Adult Mental Health Targeted Case Management (AMH-TCM)
  • Diagnostic Assessment (DA)
  • Mental Health Targeted Case Management (MH-TCM)
  • Mental Health Provider Travel Time
  • • Outpatient Mental Health Services
  • Adult Day Treatment
  • Children’s Mental Health Clinical Care Consultation
  • Explanation of Findings
  • • Mental Health Medication Management
  • Neuropsychological Services
  • Partial Hospitalization Program
  • Psychotherapy
  • Psychotherapy for Crisis
  • Psychological Testing
  • Dialectical Behavior Therapy Intensive Outpatient Program (DBT IOP)
  • • Rehabilitative Mental Health Services
  • Assertive Community Treatment (ACT)
  • Adult Day Treatment
  • Adult Rehabilitative Mental Health Services (ARMHS)
  • Certified Peer Specialist Services
  • Children’s Mental Health Residential Treatment
  • Children’s Therapeutic Services and Supports (CTSS)
  • CTSS Children’s Day Treatment
  • Intensive Residential Treatment Services (IRTS)
  • Youth Assertive Community Treatment (Youth ACT)
  • • Physician Mental Health Services
  • Health and Behavior Assessment/Intervention
  • Inpatient Visits
  • Psychiatric Consultations to Primary Care Providers
  • Physician Consultation, Evaluation and Management
  • Units (bases for measurement)

    In the case of time as part of the code definition, follow HCPCS and CPT guidelines to determine the appropriate unit(s) of time to report. Per the guidelines, providers must spend more than half the time of a time-based code performing the service to report the code. If the time spent results in more than one and one half times the defined value of the code, and no additional time increment code exists, round up to the next whole number. The following is an example if the unit of measurement is 15 minutes or 60 minutes:

    15 minutes



    0 - 7


    8 - 15


    60 minutes



    0 - 30


    31 - 60


    Outcome Measures Reporting

    The Minnesota Department of Human Services (DHS) requires regular reporting of client outcomes information for publicly funded mental health services using the Mental Health Information System (MHIS) for adults, and the Children’s Mental Health (CMH) Outcome Measures Reporting System for adolescents. DHS uses this information in the analysis of those services to assist in policy development, program management, services administration and federal mandated reporting.

    Mental Health Information System (MHIS): DHS requires MHCP mental health service providers to use MHIS for adult recipients. MHIS provides two methods of reporting; an individual web-based data entry and batch submissions of data. For more information on reporting criteria, batch reporting resources, and to sign up for MHIS email updates or join the MHIS monthly user call, visit the MHIS technical assistance webpage.

    CMH Outcome Measures Reporting System: DHS requires children’s mental health service providers to utilize the Child & Adolescent Service Intensity Instrument (CASII) or Early Childhood Service Intensity Instrument (ECSII) and the Strengths and Difficulties Questionnaire (SDQ) for children receiving publicly funded clinical services. Complete the CASII and SDQ on every child (six years of age and older) receiving clinical mental health services at intake, at least every six months and at discharge. Complete the ECSII and SDQ on young children (under 6 years of age) at intake, at least every six months, and at discharge. Find more information on reporting criteria and deadlines in DHS bulletin 17-53091 (DHS Updates Requirement for Standardized Outcome Measures for Children’s Mental Health). You can get technical assistance and contact information for the CMH Outcome Measures Reporting System in the Children’s Mental Health Outcome Measures Reporting System Manual (PDF).

    Noncovered Services

    The following are not covered MHCP mental health services:

  • • Mental health services provided by a non-psychiatrist, except psychological testing, to a recipient who is a hospital inpatient and has a mental illness diagnosis (these services are included in the hospital’s payment)
  • • Mileage (provider travel time is not the same as mileage)
  • • Transporting a recipient, except for case managers
  • • Telephone calls, unless otherwise specified in service coverage sections (example: adult MH-TCM)
  • • Written communication between provider and recipient
  • • Reporting, charting and record keeping (these activities are considered part of providing services)
  • • Community planning or consultation; program consultation, monitoring and evaluation; public information; training and education activities; resource development and training activities
  • • Fund-raising
  • • Court-ordered services for legal purposes
  • • Mental health services not related to the recipient’s diagnosis or treatment for mental illness
  • • Services dealing with external, social or environmental factors not directly addressing the recipient’s physical or mental health
  • • Staff training
  • • Mental health case management for recipients receiving similar services through the Veterans Administration (VA)
  • • Duplicate services
  • • Mental health services provided by a school or local education agency, unless the school or agency is an MHCP-enrolled provider and the services are medically necessary and prescribed in the child’s ITP or IEP
  • • Mental health services provided by an entity whose purpose is not health service related (for example, services provided by the Division of Vocational Rehabilitation or Jobs and Training)
  • • Legal services, including legal advocacy, for the recipient
  • • Information and referral services included in the county’s community social service plan
  • • Outreach services through the community support services program
  • • Assistance in locating respite care, special needs day care, and assistance in obtaining financial resources, except when these services are provided as part of case management
  • • Client outreach
  • • Recreational services, including sports activities, exercise groups, craft hours, leisure time, social hours, meal or snack times, trips to community activities, etc.
  • Legal References

    Minnesota Statutes 147 Board of Medical Practice (for psychiatrist licensure requirements)
    Minnesota Statutes 148
    Public Health Occupations
    Minnesota Statutes 148.171 – 148.285
    Minnesota Nurse Practice Act
    Minnesota Statutes 148.88 – 148.98
    Minnesota Psychology Practice Act
    Minnesota Statutes 148.907
    Licensed Psychologist
    Minnesota Statutes 148.925
    Minnesota Statutes 148B.29 to 148B.39
    Marriage and family therapy
    Minnesota Statutes 148D.055
    Board of Social Work, License Requirements
    Minnesota Statutes 245
    Department of Human Services
    Minnesota Statutes 245.461 – 245.486
    Adult Mental Health Act
    Minnesota Statutes 245.487 – 245.4887
    Children’s Mental Health Act
    Minnesota Statutes 245.4889 – 245.490
    Children’s Mental Health Grants
    Minnesota Statutes 245.491 – 245.90
    Children’s Mental Health Integrated Fund
    Minnesota Statutes 256B
    Medical Assistance for Needy Persons (includes covered mental health services)
    Minnesota Statutes 256L.03
    MinnesotaCare, Covered Health Services
    Minnesota Rules 9505
    Health Care Programs
    Minnesota Rules 9505.0322
    Mental Health Case Management Services
    Minnesota Rules 9505.0370 – 9505.0372
    Outpatient Mental Health Services (Rule 47)
    Minnesota Rules 9505.0540
    Criteria for Readmissions
    Minnesota Rules 9505.2175 – 9505.2180
    Health Service Records, Financial Records, Access to Records
    Minnesota Rules 9505.5000 – 9505.5105
    Conditions for MA and GAMC Payment
    Minnesota Rules 9520
    Mental Health Services
    Minnesota Rules 9520.0750 – 9520.0870
    Mental Health Center and Mental Health Clinic Standards (Rule 29)
    Minnesota Rules 9520.0900 – 9520.0926
    Case Management for Children with SED (Rule 79)
    Minnesota Rules 9535.4068
    Standards for Family Community Support Services for Children with SED and their Families (Rule 15)
    42 CFR 435.1008
    1009 (IMD) FFP in expenditures for medical assistance for individuals who have declared United States citizenship or nationality…; Institutionalized individuals
    42 CFR 440.60
    (a) Medical or other remedial care provided by licensed practitioners
    42 CFR 440.160
    Inpatient psychiatric services for individuals under age 21
    42 CFR 440.170
    (e) Any other medical care or remedial care recognized under State law and specified by the Secretary, Emergency hospital services
    42 CFR 440.230
    Sufficiency of amount, duration, and scope
    Title XIX, Section 1915(g)
    of the Social Security Act (MH-TCM)

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