Acupuncture Enrollment Criteria and Forms

Revised: July 18, 2023

Minnesota Health Care Programs (MHCP) requires providers to enroll for the services they provide to MHCP members to receive reimbursement. Acupuncturists may enroll with MHCP as individuals. An individual must be licensed to enroll as an individual acupuncturist with MHCP. The following licensed practitioners may provide acupuncture:

· Acupuncturists

· Chiropractors who have complied with the Minnesota Board of Chiropractic Examiners acupuncture registration requirements

How to Enroll

Providers 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) or Managed Care Organization In-network Provider Agreement (DHS-8355)

· Copy of your acupuncture license

or

Submit Forms via Fax

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

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

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

· A copy of your acupuncture license

· EFT Supplier ID Notification (DHS-3725) (PDF) (optional) if the individual is a pay-to provider and enrolled as a fee-for-service provider.

Enrollment Requirements

The following enrollment requirements apply for acupuncturists and chiropractors:

Acupuncturists

· A person is eligible to enroll as an acupuncturist if they hold a license to engage in the practice of acupuncture from the Minnesota Department of Health.

· Acupuncturists practicing outside Minnesota must comply with the licensure requirements of the state in which they practice.

Chiropractors

· Chiropractors must comply with the Minnesota Board of Chiropractic Examiners (MBCE) acupuncture registration requirements and provide a copy of the MBCE acupuncture registration to Minnesota Health Care Programs (MHCP).

· Fee-for-service claims submitted for acupuncture services will deny if MHCP has not received the MBCE registration.

· Chiropractors practicing chiropractic medicine outside Minnesota must comply with the acupuncture licensure and registration requirements in the state in which they practice.

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

We process forms in order of date 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.

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 Changes to Enrollment in the Enrollment with Minnesota Health Care Programs (MHCP) section of the MHCP Provider Manual.

Additional Resources

Minnesota Statutes 256.B.025, subdivision 8f (Acupuncture services)
Minnesota Statutes 147B.01, subdivision 3 (Acupuncture practice)
Minnesota Statutes 147B.02 (Licensure)

Minnesota Rules 9505.0195 (Provider participation)
Minnesota Rules 9505.0205 (Provider records)