Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Home health agency services

Page posted: 10/1/14

Page reviewed: 7/13/26

Page updated: 7/13/26

Legal authority

Minn. Stat. §256B.0651, Minn. Stat. §256B.0652, Minn. Stat. §256B.0653, Minn. Stat. §256B.0625 subd. 6A, 42 CFR 440.70

Definition

Home health agency services: Services a home health agency provides to a person with medical needs due to illnesses, disabilities or physical conditions.

Overview

Home health agency services are available to people using:

  • · Medical assistance (MA) (fee-for-service and managed care).
  • · Alternative Care (AC).
  • · Brain Injury (BI) Waiver.
  • · Community Access for Disability Inclusion (CADI) Waiver.
  • · Community Alternative Care (CAC) Waiver.
  • · Developmental Disabilities (DD) Waiver.
  • · Elderly Waiver (EW).
  • People may receive home health agency services and personal care assistance (PCA)/Community First Services and Supports (CFSS) or home care nursing (HCN) services.

    Home health agencies require a Medicare certification and a comprehensive license from the Minnesota Department of Health (MDH).

    An agency’s registered nurse or appropriate therapist must conduct an assessment within 30 days of a person’s request for home health agency services to determine the person’s need for service.

    Services

    Home health agencies can provide the following services:

  • · Home health aide (HHA).
  • · Home health therapies.
  • · Skilled nursing visit (SNV).
  • · Extended home care services.
  • This page describes general information applicable to all home health agency services. For more information on the documentation and process for each service, refer to the applicable page.

    Covered and non-covered locations

    Home health agencies can deliver services in the following locations:

  • · Person’s place of residence.
  • · Community settings.
  • Home health agencies cannot deliver services in the following locations:

  • · Hospital.
  • · Nursing facility.
  • · Intermediate care facility for persons with developmental disabilities (ICF/DD) (except in certain circumstances; refer to the ICF/DD exception on CBSM – SNV).
  • Face-to-face visit requirement

    All home health agency services require a face-to-face visit at the start of services, in addition to any other prior authorization requirements. This requirement applies to all people who use home health agency services.

    Exception

    The face-to-face requirement does not apply when a person receives an SNV as a one-time perinatal visit (i.e., for a person who is pregnant or recently gave birth).

    Process

    The person’s physician, physician’s assistant (PA) or advanced practice nurse (APRN) can conduct a face-to-face visit in person or through telehomecare. This visit must:

  • · Occur within 90 days before or 30 days after the start of services.
  • · Address the primary reason the person needs home health agency services.
  • · Be completed by a physician, PA or APRN licensed in Minnesota.
  • Documentation

    The home health agency’s documentation must include all the following information:

    1. The name of the qualified provider who completed the visit.

    2. The date the provider completed the visit.

    3. Confirmation that:

  • · The person’s medical record includes all clinical findings of the visit.
  • · The visit is related to the primary reason the person needs home health agency services.
  • · The visit occurred within the required timeline.
  • The home health agency must:

  • · Keep the required documentation as part of the person’s record.
  • · Only bill if the required documentation is part of the person’s record.
  • · Submit the required documentation to DHS or the person’s managed care organization upon request.
  • The ordering practitioner does not have to be the same individual as the qualified provider who performs the face-to-face visit. If a qualified provider other than the ordering practitioner completes the face-to-face visit, the provider must send the documentation, including clinical findings of the visit, to the person’s ordering practitioner.

    Additional resources

    CBSM – Extended home care services
    CBSM – HHA
    CBSM – Home health therapies
    CBSM – SNV
    MDH – Health care provider directory
    MDH – Home care and assisted living
    MHCP Provider Manual – Home care services

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