Minn. R. 9505.0415, subp. 1 through 7

Leave day: Any 24-hour period that ends at midnight during which the recipient leaves the facility and is absent overnight as well as all subsequent, consecutive calendar days for the same purpose. An overnight absence from the facility of less than 23 hours does not constitute a leave day.

Hospital leave: Status of a recipient transferred from the ICF/DD to an inpatient hospital for medically necessary health care with the expectation the recipient will return to the ICF/DD.

Reserved bed: Same bed a recipient occupied before they were transferred to the hospital or an appropriately certified bed if the recipient’s physical condition prohibits access to the bed occupied before the recipient left the ICF/DD.

Separate and distinct episode: Any one of the following:

A hospital leave day is eligible for MA payment subject to the following:

A hospital leave day is not eligible for MA payment subject to the following:

Hospital leave day payment is limited to 18 consecutive days for each “separate and distinct episode.” There is no yearly limit of days.

1. Document the date and the time a recipient leaves the ICF/DD and the date and time the recipient returns to the facility in the recipient’s health record.

2. Report hospital leave days on the occupancy form submitted monthly to DHS ICF/DD Staff. For more information, refer to ICF/DD Manual – Occupancy Report.

Return funds billed and paid for hospital leave day(s) that were not eligible for MA payment to the State of Minnesota within 30 days of the error.

To submit claims electronically, use MN-ITS.

To submit paper claims, use the UB-92 claim form. Billing instructions are in the MHCP Provider Manual – Billing Policy Overview.

For more information, contact DHS – MHCP Provider Resource Center at (651) 431-2700 or (800) 366-5411.