• Secure FTP users only: The SFTP server will be unavailable from Sunday, Oct. 11, 2015, at 6 p.m. to Monday Oct. 12, 2015, at 6 a.m. for upgrade and maintenance. You will not be able to submit any files during this time. (Added 10/6/15)
• Legislative changes to rates: We have completed system work to implement the following July 1, 2015, legislative changes:
• Outpatient hospital medical supplies, durable medical equipment, and prosthetics and orthotics (not subject to volume contracts) and laboratory services to a hospital that meet criteria specified in Minnesota Statutes 62Q.19, Subd. 1 (a) (4) were increased by 90 percent. This increase does not apply to Medicare crossover claims.
• Medical supplies, durable medical equipment, prosthetics and orthotics will increase by 3 percent.
The reprocessed affected claims will be on your Oct. 20, 2015, remittance advice. Medical supplies, durable medical equipment, prosthetics and orthotics claims with dates of service prior to July 1, 2015, on which the 3 percent increase was incorrectly applied will be reprocessed in the next few weeks. (Added 10/6/15)
• Revalidation letters: All PCA agencies have received revalidation letters in their provider MN–ITS mailboxes. You must complete revalidation to maintain your status as an enrolled provider with MHCP. MHCP is offering several optional PCA revalidation workshops to help providers fill out the revalidation forms correctly.
• Quality Improvement Tool: Providers must submit quality improvement projects to DHS by Dec. 31, 2015, to receive the full July 2015, 1 percent rate increase. For more information on the process and how to submit your plan, see the 2015 Quality Improvement Tool announcement (PDF). For more information on the 2015 quality-improvement requirements, see the DHS long-term services and supports rates changes page. (Added 10/8/15)
• Denied claims: MHCP identified an issue on claim type 837I, Outpatient Claim, processed from Aug. 25 through Sept. 9, 2015. Some claims that were submitted with revenue codes denied in error for a missing, incomplete or invalid procedure code. We will reprocess these denied claims on the Sept. 22, 2015, remittance advice (RA). If after reviewing your RA for the corrected claim you find additional claims that need to be replaced, notify the MHCP Provider Call Center with the denied claims payer claim control number.
• End of session summary: Review the 2015 Community Supports End of Session Summary (PDF). This summary includes health and human services budget and policy bill requirements that affect disability services, deaf and hard of hearing services, chemical and mental health, and housing.
Refer to the Provider Training page for information about new and ongoing training or to the sessions listed below for details on additional training sessions on special topics:
• Postponed: Introduction to the Positive Supports Rule Session (Sept. 22, 2015)
The Sept. 22, 2015, session for The Positive Support Community of Practice: Introduction to the Positive Support Rule (Minnesota Rules, Chapter 9544) has been postponed. The new date will be finalized in the upcoming days. Please check our Training News and Information page or subscribe to our eList to receive the new date and time once it is announced.
• Early Intensive Developmental Behavioral Intervention (EIDBI)
DHS is offering in-person and webinar training sessions for Comprehensive Multi-Disciplinary Evaluation (CMDE) and Individual Treatment Plan (ITP) for interested and enrolled Early Intensive Developmental Behavioral Intervention (EIDBI) providers. Refer to the EIDBI Training web page for more information.
• Adult Rehabilitative Mental Health Services (ARMHS) Information Seminar
Providers interested in becoming an ARMHS provider are required to attend an ARMHS Information Seminar. Qualified clinical supervisors or clinical consultants, as well as the administrative representative of the potential ARMHS provider must register for the seminar. DHS provides these seminars quarterly. Seminars will be Oct. 16, 2015, Jan. 15, 2016, and April 15, 2016. All seminars will be on Fridays from 8:30 a.m. to 12:30 p.m. Information to enroll in the seminar, as well as additional information about the clinical supervisors’ prerequisite online training is on the AMHD Training Website.
Announcements and availability
Watch the 5010/D.0 Announcements page for information about MN–ITS functionality, technical information, scheduled downtimes and other notifications.
ICD-10 is here
MN–ITS is ready for ICD-10 – are you? All MHCP health care transactions for dates of service on or after Oct. 1, 2015, must include ICD-10 diagnosis codes for reporting a diagnosis. However, you must continue to submit ICD-9 codes for dates of service before Oct. 1, 2015. MHCP will deny claims for the following:
• A claim will be denied if you report ICD-9 codes for dates of service, or dates of discharge, on or after Oct. 1, 2015.
• A claim will be denied if you report ICD-10 codes for dates of service, or dates of discharge, before Oct. 1, 2015.
Some providers may experience difficulty submitting claims with ICD-10 codes through their organization’s systems. If you have difficulty with your billing system, you may submit claims with ICD-10 codes through MN–ITS. Refer to the following for more information:
MEIP simplified requirements
The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator (ONC) for Health Information Technology released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available when and where it matters most. The rules also help health care providers and consumers to be able to readily, safely, and securely exchange that information. For more information, refer to the following:
The new rule requires modification to the MN EHR Incentive Program (MEIP) provider attestation portal. We will tell you more about this soon. However, the MEIP attestation system remains open for Program Year 2015 attestations for AIU or Year 1 Meaningful Use (90 day).
Tier e-Tool – ICD-10
Effective Oct. 1, 2015, all transactions in the Tier e-Tool require ICD-10 diagnosis codes. Refer to the MHCP ICD-10 web page for more information and resources on the ICD-10 transition.
Hospice Payment Rule
MHCP is working to implement changes required for the CMS finalized hospice payment rule for fiscal year 2016. For more information about the upcoming changes, refer to the following resources:
Outpatient Direct Observation
We have completed the system work for outpatient direct observation services. Effective for dates of service on or after July 1, 2015, claims will be priced following the Centers for Medicare & Medicaid Services (CMS) guidelines using the outpatient ambulatory payment classification payment rate. We will reprocess claims with dates of service on or after July 1, 2015, through Sept. 9, 2015, on your Oct. 20, 2015, remittance advice. (Added 10/6/15)
Outpatient hospital fetal monitoring billing
Providers billing for outpatient fetal monitoring must bill using revenue code 0762 and the appropriate fetal monitoring procedure code on the 837I outpatient claim. Refer to the MHCP Provider Manual Outpatient Hospital Services, Billing Policy for details.
Outpatient prospective payment system
Extended Assessment and Management Services: MHCP identified an error when processing extended assessment and management services. We are working on a programming change to price claims following Centers for Medicare & Medicaid Services (CMS) guidelines for procedure codes 99284, 99285, 99291, G0378, G0379, G0384 or G0463 billed on an 837I outpatient claim. This correction will be retroactive for dates of service on or after Jan. 1, 2014. MHCP will retroactively reprocess claims after this programming is complete and will post a new message indicating the remittance advice date for the reprocessed claims at that time.
Comprehensive APC Payment Rates (C-APC) Payment Status Indicator J1: MHCP continues to review programming options to implement the CMS C-APC pricing logic that began on Jan. 1, 2015. Once programming is completed, we will reprocess claims with dates of service on or after Jan. 1, 2015. We will update this message with the ongoing status of this project. Once the project is complete, we will provide a timeline for reprocessing claims that includes the remittance advice date for the reprocessed claims.
ICD-10 Codes and Mental Health Information System (MHIS)
MHIS will accept only ICD-10 codes for diagnostic assessments done on orafter Oct. 1, 2015.
The system will continue to accept ICD-9 codes for diagnostic assessments done before Oct. 1, 2015.
Rate increase adjustment to ARMHS services
On Aug. 11, 2015, the Centers for Medicare & Medicaid Services (CMS) approved the rate increases for ARMHS. MHCP will complete a mass adjustment to reimburse providers back to Jan. 1, 2015. Reimbursement for previously processed claims will be on the October 20 remittance advice. (Added 10/8/15)
Rate increase and new services
On Aug. 11, 2015, CMS approved the rate increases and two new billable services for ARMHS. We updated the ARMHS section in the MHCP Provider Manual with new policy requirements to bill the functional assessment (FA) and individual treatment plan (ITP). The FA and ITP have yearly thresholds. Refer to Billing in the ARMHS section for the modifiers and thresholds. Certified ARMHS provider organizations can register for training at ARMHS revisions: a seminar for certified provider organizations (MH131).
Billing for FA and ITP is effective Sept. 15, 2015; however, the system is not yet programmed to accept billing for these services. We will notify providers when the system is updated to bill for the services. For the existing ARMHS services, DHS will do a mass adjustment to reimburse providers back to Jan. 1, 2015. We will post a new message when we do the mass adjustment.
Personal Care Assistance (PCA)
Revalidation paperwork workshop
To help you understand the revalidation process, MHCP is offering PCA provider agencies an opportunity to bring the forms for revalidation to a workshop and get help filling them out. Please register at the PCA Provider Agency Revalidation Workshop.
Remember to use ICD-10 diagnosis codes on service agreements for dates of service on or after October 1, 2015.
Ambulance transportation services
Effective for dates of services on or after Oct. 1, 2015, enter a valid ICD-10 diagnosis code on all ambulance service claims indicating the condition of the client or patient requiring the level of service billed. MHCP will not establish a list of acceptable ICD-10 diagnosis codes for ambulance service codes A0427, A0433 and A0429. Use the most appropriate ICD-10 code.
Access transportation services (ATS) and special transportation services (STS)
Effective for dates of services on or after Oct. 1, 2015, counties, tribes, MinnesotaCare staff, and enrolled transportation providers must include a valid ICD-10 diagnosis code on all claims for access transportation services (ATS), the related ancillary services, and special transportation services (STS). Transports are considered administrative services; the suggested ICD-10 diagnosis code to submit on these claims is Z02.9 – encounter for administrative examinations; unspecified.
Waiver and AC Program Providers
Changes to Disability Waiver Rate System frameworks
Beginning Jan. 1, 2016, DHS will implement the following two changes in the Disability Waiver Rates System:
• The first will account for regional differences in waiver-service costs
• The second will authorize a transportation framework for full-day DT&H services.
DHS will integrate both changes with the Rate Management System (RMS). Implementation will occur on a rolling basis as service authorizations either renew or change.
Due date extended for Disability Waiver Rate System Research
DHS placed letters in some providers MN–ITS mailboxes on Aug. 31, 2015. If you were one of the randomly selected providers, the link to the letter is in your PRVLTR file and is titled “ExceptionLetter.” Only a limited number of providers from specific service categories received a letter; you do not need to call if you do not have a letter. If you received a letter, note that the due date has been extended to Sept. 18, 2015. Your participation in this Disability Waiver Rate System (DWRS) exceptions research will play a major role in how the DWRS operates in the future. DHS will use the data collected to estimate the future fiscal impact of rate exceptions on HCBS disability waiver programs, lead agency budgets, and service rates calculated in the DWRS. Provider information is key to this research. Please take a few minutes to complete this information.
Visit our Provider website for more comprehensive information, including these pages: