Financial Management Services (FMS)

Revised: August 18, 2026

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Noncovered Services

· Service Authorization Requirements

· Documentation

· Billing

Overview

Financial management services (FMS) providers help with financial tasks, billing and employer-related responsibilities for Minnesota Health Care Programs (MHCP) members who self-direct their services through:

· Consumer Directed Community Supports (CDCS),

· Consumer Support Grant (CSG), or

· Community First Services and Supports (CFSS)

· the CFSS budget model

· purchasing goods or services within the CFSS agency model

Eligible Providers

An FMS provider must meet all the following qualifications:

1. Successfully complete a readiness review before enrollment, conducted by a member or organization that meets the qualifications required by the state.

2. Be a financially solvent organization.

3. Have all the following:

· Current and adequate liability insurance and bonding as defined in the RFP.

· Knowledge of and compliance with Internal Revenue Service (IRS) requirements.

· An information technology security officer.

· A certified payroll professional, a certified public accountant or an individual with a bachelor’s degree in accounting.

· An electronic tracking, reporting and verification software product that can report and analyze data on people who receive services and support workers

· The ability to provide services statewide.

· The ability to meet the requirements under a collective bargaining contract.

· An established customer service system.

The Minnesota Department of Human Services (DHS) determines if FMS providers meet these qualifications through a Request for Proposal (RFP) process. FMS providers are required to go through the RFP process periodically as determined by DHS. To view open RFPs, refer to the Grants and RFPs website. DHS contracts with all FMS providers who successfully complete the RFP process to provide FMS services.

Requirements to act as agent of the MHCP member
FMS providers (referred to as “vendor fiscal/employer agents” in state contracts) must comply with Section 3504 of the Internal Revenue Service (IRS) Code and Revenue Procedure Code 2013-39, as applicable.

The previously listed federal authority requires an FMS provider to:

· Obtain an IRS authorization from the member to act as an agent for them.

· Be able to advise the member about their obligations for workers’ compensation.

· Help the member obtain workers’ compensation, if needed, and any other required insurance.

FMS providers must enroll individual direct support workers with MHCP
FMS providers must enroll and affiliate individual direct support workers with their organization. Before enrolling and affiliating a direct support worker, each FMS provider must verify the worker meets the requirements listed in Direct Support Worker (DSW), Individual Enrollment Criteria and Forms for the program the direct support worker will be enrolled in.

FMS providers must submit spreadsheets for CFSS budget model, CDCS and CSG workers
FMS providers must have policies and procedures in place to ensure that members using CFSS budget model, CDCS or CSG follow the requirements in the Service Employees International Union (SEIU) Healthcare Minnesota and Iowa contract. DHS requires FMS providers to submit spreadsheets tracking required data for workers. Review the SEIU collective bargaining agreement contract compliance course for how to correctly complete and submit spreadsheets.

· Instructions for submitting CFSS Budget Model-PCA Choice-CDCS-CSG Reporting Spreadsheet through MN–ITS (PDF) 

· CFSS Budget Model-PCA Choice-CDCS-CSG Reporting Spreadsheet (XLS)

Eligible Members

Members are eligible to use FMS under the following programs:

· Consumer Directed Community Supports (CDCS)

· Consumer Support Grant (CSG)

· Community First Services and Supports (CFSS):

· Members who use the CFSS budget model

· Members who choose to purchase goods or other services within the CFSS agency model

FMS providers must verify program eligibility for each member monthly through the MHCP phone-based eligibility verification system or online via MN–ITS.

Covered Services

The following financial management services are covered:

· Billing DHS and paying vendors or the person’s individual workers for authorized goods and services.

· Ensuring expenses follow the rules of the program and lead-agency-approved plan.

· Helping the person obtain workers’ compensation.

· Educating the person on how to employ workers.

· Documenting and reporting all spending of program funds.

· Initiating background studies for workers.

· Filing federal and state payroll taxes for workers on the person’s behalf.

Financial management services must be:

· Provided to an eligible member.

· Approved with a prior authorization by a lead agency.

· Included in the member’s CDCS community support plan, CFSS service delivery plan or CSG plan approved by a lead agency.

Noncovered Services

The following services are not covered:

· Services that are not specified in the member’s plan that was approved by the lead agency.

· Services provided without authorization from the lead agency.

Service Authorization Requirements

All CDCS, CSG and CFSS services require a lead agency to complete a service authorization. A provider will not receive payment for services without an approved service authorization. However, an approved service authorization is not a guarantee of payment.

For DHS to pay claims:

· Providers must be actively enrolled and have current credentials to provide the approved service(s).

· The member must maintain their MHCP eligibility for the authorization to be valid.

Providers are responsible for ensuring the service authorization is accurate when they receive their service authorization letters in their MN–ITS mailbox.

Service authorization may not be issued to more than one FMS provider for the same member for the same dates.

Service authorization for CDCS, CSG and CFSS are modified in the following way:

· Case managers and care coordinators update service authorizations for people who receive waiver services or Alternative Care (AC) and receive CDCS, CSG or CFSS services.

· DHS only updates CFSS service authorizations for people not on a waiver or AC and who are not receiving CFSS services through a managed care organization (MCO). Refer to PCA/CFSS service agreement technical changes and corrections in the CFSS Policy Manual.

Documentation

FMS providers must keep documentation in their records to support the services provided before billing covered services to MHCP for reimbursement.

· Providers must collect and maintain readable documentation in English.

· Providers may collect and maintain documentation electronically or in paper form and must produce documentation upon the DHS commissioner’s request.

· Providers must maintain records to ensure a clear audit trail and track all spending.

For services authorized using an hourly or minute-based unit, the provider must document:

· The date of the documentation

· The day, month and year the service was provided

· The start and stop times with a.m. and p.m. designations

· Service name or description

· The name, signature and title, if any, of the person providing the service. If more than one staff member provides the service, the provider may designate one staff member responsible for verifying services and completing the documentation required.

For services authorized using a unit other than hourly or minute-based (such as daily or per occurrence), the provider must document:

· The date of the documentation

· The day, month and year the service was provided

· Service name or description

· The name, signature and title, if any, of the person providing the service. If more than one staff member provides the service, the provider may designate one staff member responsible for verifying services and completing the documentation required.

In addition, FMS providers are responsible for reviewing the service-specific documentation sections for each program to ensure compliance with all documentation requirements. Providers can find the policy manual for each program in the Eligible Members section of this page.

CFSS and CSG
FMS providers must have documentation supporting that a direct support worker provided covered services. MHCP requires FMS providers to verify that the worker documents all the required information. The FMS provider is responsible for ensuring the worker records this in their organizations’ PCA/CFSS personal care time and activity documentation process. FMS providers may use their EVV system or a combination of their EVV system and the CFSS Worker Time and Activity Documentation (DHS-6893C) (PDF) to capture all the required components for documenting time and activities. FMS providers determine the documentation methods used for recording time and activity. FMS providers must ensure compliance with both Electronic visit verification (EVV) and documenting time and activities of covered services.

CDCS
In addition to EVV, FMS providers must follow all documentation requirements listed in Minnesota Statutes, 256B.4912 for Home and Community-Based Services (HCBS) providers for all CDCS services.

Billing

A member cannot bill MHCP directly for approved services. Only an FMS provider can submit claims and receive payments from MHCP. These payments are used to pay workers and to pay for approved goods and other services. Refer to the Billing Policy Overview section of Provider Basics for MHCP general billing policies.

Bill only for services that are documented and approved in the service authorization (SA) and have already been provided.

· Bill on 837P claim format.

· Enter a diagnosis code. Use the most current and approved diagnosis code on the service authorization (SA).

· Enter the approved SA number in the claim.

For step-by-step instructions on how to submit an 837P professional claim, refer to the Basic instructions in the MN–ITS user manual for submitting DDE claims.

FMS providers delivering CDCS, can refer to the Submitting Claims section for billing waiver and Alternative Care (AC) program claims.

CFSS Billing Codes
Refer to the Long-Term Services and Supports Service Rate Limits for a complete list of CFSS procedure codes and modifiers. Some modifiers are claim-only and do not require to be on the service authorization. Refer to the Submitting CFSS claims section of the CFSS Provider Manual for more information about billing specific CFSS covered services.

CDCS Billing Codes

CDCS Service Name	Procedure code	Mod
CDCS: Personal care assistance	T2028	U1
CDCS: Treatment and training	T2028	U2
CDCS: Environmental modifications and provisions	T2028	U3
CDCS: Self-direction support activities	T2028	U4
CDCS: Self-direction support activities, support planner	T2028	U8
CDCS: Financial management services	T2028	U5
CDCS: Community integration and support	T2028	U6
CDCS: Environmental modifications - vehicle modifications	T2028	UA
CDCS: Environmental modifications - home modifications	T2028	UB
CDCS: Support planner	T2028	UC
CDCS: Individual directed goods and services:	T2028	U9
CDCS: Background Check	T2040

Modifier 76 with T2028
When you have already billed for one or more of the same CDCS T2028 covered services for the same member and on the same date of service, include the modifier 76 on the additional claim(s) to avoid a duplication of service denial.

Example:

· Original Claim: Bill for T2028 CDCS services with the allowable modifier.

· Include the allowable modifier for the CDCS service provided in the 1st Modifier field on the claim.

· Additional charges: for the same date of service (DOS), for the same member, with the allowable modifier already billed:

· Enter the same modifier from your original claim in the 1st Modifier field and modifier 76 in the 2nd Modifier field on any claims with additional charges.

FMS providers do not use modifier 76 on their original claim or on claims when billing for the same date of service for a member that includes a different allowable modifier for T2028.

CSG Billing Codes

CSG Service Name	Procedure code
CSG: All claims	T2025