Disability Determinations/ Requests – SMRT
The Minnesota Legislature expanded the role of SMRT in collecting evidence used for disability determinations. The county continues to coordinate the initial application process, but SMRT collects any additional information that is needed. This includes working with the applicant/recipient, counties and providers to schedule exams, other tests, and transportation, as necessary.
SMRT reviews the evidence to determine if a decision can be made. If not, SMRT will work with the applicant and provider to collect any additional information needed to make the determination, including medical examination, psychological evaluation, or other applicable tests.
Request for Additional Information
When SMRT needs additional information to make a disability determination, SMRT case managers fax to provider(s):
Submit documents to SMRT using secure fax or mail for information that cannot be faxed:
DHS – SMRT
Scheduling Exams and Transportation
When an examination, evaluation, or other test is required, SMRT works with the applicant/recipient and provider to schedule the appointment and provide transportation, as needed, (through MNET or the county).
SMRT will authorize payment for the appointment by:
Providers may retrieve the authorization letter in their MN–ITS Mailbox Miscellaneous Received PAL file type folder.
Counties that schedule and pay for SMRT evaluations and medical records must email or call SMRT at 651-431-2493 or 1-800-235-7396 with the following information to obtain an authorization:
The recipients MHCP eligibility may currently show as ineligible when verified. However; the authorization approves the MHCP enrolled provider who is listed on the authorization to bill for and receive payment from MHCP for rendering exams, evaluations or other tests.
MHCP reimbursement for CPT 99456 Disability Examination allows the claim to pay at 100% of the providers’ total submitted charge.
The CPT code 99456 includes all components of the medical disability examination. Providers must add all of their usual/customary charges for each service performed (including ancillary services that were sent to an outside lab or other provider) to calculate the total charge amount. The authorized provider must have a contractual agreement to pay for any ancillary services sent to an outside lab or other provider.
Counties add all payments made for medical records, transportation, and exams to calculate the total charge amount.
Providers must bill and receive payment from primary coverage to the fullest extent possible before billing MHCP for recipients who have other health insurance.
General billing guidelines:
For billing instructions using MN–ITS, refer to the MN–ITS SMRT Disability Examination user guide.
MS 256.01, subd. 29 Commissioner of Human Services; Powers, Duties. State medical review team.
If you have billing questions, call the MHCP Provider Call Center at 651-431-2700 or 1-800-366-5411.Report/Rate this page