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:
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.
Clinical supervision is the process of control and direction of a recipient’s mental health services by which a 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 enrollment as a Medicare provider is denied, 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) 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. A request for a review of the county decision may be submitted to the Adult or Children’s Mental Health Division:
(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 JCAHO-accredited psychiatric facility and meets one of the following criteria:
Recipients age 21 years and over but under age 65 years 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 eligibility criteria are met. The recipient, if discharged within 180 days 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:
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
Qualified Medicare Beneficiary
Some MH services may be delivered by Telemedicine. Review also the MHCP MH Code and Rates Chart (PDF).
The following are covered mental health services (refer to the linked sections for additional service-specific information):
The following are not covered MHCP mental health services:
MS 147 Board of Medical Practice (for psychiatrist licensure requirements)
MS 148 Public Health Occupations
MS 148.171 – 148.285 Minnesota Nurse Practice Act
MS 148.88 – 148.98 Minnesota Psychology Practice Act
MS 148.907 Licensed Psychologist
MS 148.925 Supervision
MS 148B.29 to 148B.39 Marriage and family therapy
MS 148D.055 Board of Social Work, License Requirements
MS 245 Department of Human Services
MS 245.461 – 245.486 Adult Mental Health Act
MS 245.487 – 245.4887 Children’s Mental Health Act
MS 245.4889 – 245.490 Children’s Mental Health Grants
MS 245.491 – 245.90 Children’s Mental Health Integrated Fund
MS 256B Medical Assistance for Needy Persons (includes covered mental health services)
MS 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)