Certified Mental Health Rehabilitation Professional Enrollment Criteria and Forms

Revised: August 4, 2023

To enroll as a certified mental health (MH) rehabilitation professional with Minnesota Health Care Programs (MHCP), a certified MH rehabilitation professional must meet the following criteria:

· Be a licensed professional clinical counselor with at least 4,000 hours of post-master’s supervised experience in the delivery of clinic services in the treatment of mental illness

· Hold a current and valid national certification as a certified rehabilitation counselor or certified psychosocial rehabilitation practitioner

· Be employed by a certified Adult Rehabilitative Mental Health Services (ARMHS) provider entity

How to Enroll

Certified MH rehabilitation professionals who wish to enroll with MHCP can do so in one of the following two ways.

Online MPSE Portal

Register to access the Minnesota Provider Screening and Enrollment (MPSE) portal and complete your enrollment online using the MPSE portal. If enrolling through the MPSE portal, you will be required to upload a:

· Completed, signed and initialed copy of the Fee-for-Service (FFS) only or FFS and Managed Care Organization In-Network Provider Agreement (DHS-4138) (PDF) or Managed Care Organization In-network Provider Agreement (DHS-8355) (PDF)

· Copy of current national certification as certified rehabilitation counselor or certified psychosocial rehabilitation practitioner

or

Submit Forms via Fax

Complete the following documents and fax your materials to MHCP Provider Eligibility and Compliance at 651-431-7462.

· Documentation of current national certification as certified rehabilitation counselor or certified psychosocial rehabilitation practitioner

· Individual – Provider Enrollment Application (DHS-4016) (PDF)

· Fee-for-Service (FFS) only or FFS and Managed Care Organization In-Network Provider Agreement (DHS-4138) (PDF) or Managed Care Organization In-network Provider Agreement (DHS-8355) (PDF)

Review and keep a copy of the MHCP Data Privacy Notice (DHS-6287) (PDF).

Forms are processed in date order received. Whether enrolling using the MPSE portal or by fax, allow 30 days for processing. If we need more information to complete your enrollment, we will send a request for more information letter via your MN–ITS mailbox or U.S. Postal Service telling you what you need to do to complete your enrollment.

Fee-for-service billing for certified MH rehabilitation professionals must be done by an MHCP-enrolled agency. MHCP does not pay certified MH rehabilitation professionals directly.

Revalidation

MHCP is required to follow the Centers for Medicare & Medicaid Services final federal provider screening regulations.

Refer to Revalidation in the Provider Screening Requirements section of the MHCP Provider Manual for more information about how to complete your revalidation.

Reporting Changes

Report any changes made on a provider record to MHCP Provider Eligibility and Compliance. Refer to the Changes to Enrollment in the Enrollment with Minnesota Health Care Programs (MHCP) section of the MHCP Provider Manual for details.

Additional Resources

Minnesota Statutes 245.462, subdivision 18 (6) (Definitions. Mental health professional)