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.
Mental health service delivery is composed of six key components:
The following diagram shows the mental health service-delivery process and the relationship between the components.
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.
The following agencies may enroll with MHCP:
The following mental health professionals may enroll with MHCP:
The following are not eligible to enroll as an MHCP provider:
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:
When Medicare denies enrollment as a Medicare provider, the following MHCP providers must submit the denial letter from Medicare to MHCP Provider Enrollment:
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.
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:
651-431-7418 (Attn: Mental Health Appeal Review)
651-431-2321 (Attn: Mental Health Appeal Review)
DHS Mental Health Division – Appeal Review
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:
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:
(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.
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
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):
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:
0 - 7
8 - 15
0 - 30
31 - 60
The following are not covered MHCP mental health services:
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 Supervision
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)