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Collaborative Practice Dental Hygienists

Revised: February 18, 2020

Overview

Collaborative practice dental hygienists must be employed or retained by one of the following Minnesota Health Care Programs (MHCP)-enrolled groups:

· Health care facility

· Program (such as Head Start)

· Nonprofit organization

Individual collaborative practice dental hygienists are not eligible for direct MHCP reimbursement.

Individual collaborative practice dental hygienists must enroll with a group affiliation to receive reimbursement at the group level for all dental hygiene services rendered to MHCP enrollees. As part of this process, MHCP requires individual National Provider Identifiers (NPIs) and affiliation with one or more of these enrolled group providers.

· Individual dental hygienists must indicate their group affiliations on their applications.

· Enrolled groups must add their enrolled collaborative practice dental hygienists to their provider file using the Organization MHCP Provider Profile Change Form (DHS-3535A) (PDF).

· Groups not yet enrolled must include individual group members, including collaborative practice dental hygienists.

For collaborative practice dental hygienists providing services to enrollees in a managed care organization (MCO), contact the MCO for enrollment requirements and coverage.

Covered Services

MHCP reimburses for covered dental services within the scope of practice of the collaborative practice dental hygienist as identified in Minnesota Statutes, 150A.10, subdivision 1a.

Billing

Bill all services completed in a collaborative practice capacity using the following:

· 837D format

· Individual collaborative practice dental hygienist NPI as the rendering provider

· Appropriate health care facility program (such as Head Start), or nonprofit NPI as the pay-to provider (provider who receives the payment)

Additional Resources

Minnesota Statutes, 150A.10, subdivision 1a (collaborative practice authorization for dental hygienists in community settings)

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