Recuperative Care Enrollment Criteria and Forms

Revised: March 25, 2026

How to Enroll

Recuperative care providers who wish to enroll with Minnesota Health Care Programs (MHCP) or make enrollment requests must follow these steps:

1. Complete and submit the Recuperative Care Provider Pre-Enrollment Risk Assessment (DHS-8747) (PDF).

2. Have a qualified inspector (not associated with the recuperative care facility or organization) complete Recuperative Care Habitability Inspection Form (DHS-8846). After the inspection is completed, the provider must submit the Recuperative Care Habitability Inspection Form (DHS-8846) along with the pre-enrollment risk assessment (PERA.)

3. In addition, call the city where your recuperative care facility is located for city, county and zoning requirements. Each city and county will have different requirements and inspections. Providers and recuperative care facilities must ensure city, county and zoning requirements are fulfilled.

· Provide a list of documents your city and county require and documentation that you meet each requirement along with your PERA.

You can only start the recuperative care enrollment process after you receive the PERA approval letter. If your PERA is denied, you cannot start recuperative care provider enrollment with MHCP. Allow 30 days from date of completed submission for processing your PERA. We will email providers (at the email address that providers include on the PERA) a letter with the approval or denial decision. However, you may resubmit the PERA if denied. Allow up to 30 days to review a PERA that is resubmitted after an initial denial.

4. Pay the application fee

5. After your Recuperative Care Provider Pre-Enrollment Risk Assessment (DHS-8747) (PDF) and Recuperative Care Habitability Inspection Form (DHS-8846) have been approved, you can enroll with MHCP via the following ways listed below:

Online MPSE Portal

Register to access the Minnesota Provider Screening and Enrollment (MPSE) portal and complete your enrollment online using the MPSE portal. Also, upload the following in the MPSE portal:

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

· Recuperative Care Provider Assurance Statement (DHS-8486) (PDF)

· Recuperative Care – Health Services Provider Acknowledgment (DHS-8562) (PDF)
Note: Any individual listed on Recuperative Care – Health Services Provider Acknowledgment (DHS-8562) must be enrolled with MHCP and disclosed in the Owners and Authorized Persons section of the MPSE portal.

· Recuperative Care Surety Bond (DHS-8748) (PDF) (upload to the notes section of MPSE)

· Proof that a fee was paid to Minnesota Department of Human Services, another state Medicaid agency, or Medicare

or

Complete and Submit Forms by Fax

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

· Organization – Provider Enrollment Application (DHS-4016A) (PDF)

· Disclosure of Ownership and Control Interest (DHS-5259) (PDF)

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

· Recuperative Care Provider Assurance Statement (DHS-8486) (PDF)

· Recuperative Care – Health Services Provider Acknowledgment (DHS-8562) (PDF)
Note: Any individual listed on Recuperative Care – Health Services Provider Acknowledgment (DHS-8562) must be enrolled with MHCP and disclosed in the Owners and Authorized Persons section of the MPSE portal.

· Recuperative Care Surety Bond (DHS-8748) (PDF)

· Proof that a fee was paid to Minnesota Department of Human Services, another state Medicaid agency, or Medicare

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

We process forms in order of date received. Allow 30 days for processing whether enrolling using the MPSE portal or by fax. We will send a request for more information letter through the U.S. Postal Service (or your MN−ITS mailbox, if you have an account) if we need more information to complete your enrollment.

Revalidation

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

MHCP will notify you when you are due for revalidation. When you are notified, you must submit a revalidation request through the MPSE portal or fax all required forms and documents to the Minnesota Department of Human Services.

Refer to Revalidation in Provider Screening Requirements under Provider Basics in the MHCP Provider Manual for important information, including timelines, about the revalidation process and impacts to your enrollment. Providers who do not meet the revalidation timelines will have their enrollment terminated.

Reporting Changes

Report any changes made on a provider record to MHCP Provider Eligibility and Compliance. Refer to Changes to Enrollment in Enrollment with MHCP under Provider Basics in the MHCP Provider Manual for details.

Legal References

Minnesota Statutes, 256B.0701 (Recuperative Care Services)