MMIS SERVICE AGMT – ASA3 screen CSG and FSE lines
Note: DHS will keep this page for historical reference during the transition from personal care assistance (PCA) and the Consumer Support Grant (CSG) to Community First Services and Supports (CFSS). For more information, refer to DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS.
Page posted: 5/20/11 | Page reviewed: | Page updated: 9/30/24 | |
Transition from CSG to CFSS | DHS is in the process of replacing personal care assistance (PCA) and the Consumer Support Grant (CSG) with Community First Services and Supports (CFSS). For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS. DHS must update the Medicaid Management Information System (MMIS) to allow counties/tribal nations to enter a CFSS service agreement (SA). Some fields have minor changes. For more information, refer to DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS. During the transition from CSG to CFSS, the county/tribal nation follows the instructions below to enter a new SA in MMIS: | ||
LI COMMENTS field | Enter a short comment (optional). Comment will appear on the recipient and provider service agreement letters. Only the provider listed in the PROVIDER NAME/NBR field of this line will see the comment. | ||
PROC field | Enter procedure code T2025 on the CSG line and the FSE line. CSG with PCA assessment, CSG combined PCA and HCN or HHAEnter CSG as two lines using procedure code T2025 (CONSUMER SUPPORT GRANT). Enter only one T2025 line for the county provider when a FSE is not used. Notice of reduction, notice of terminationEnter CSG notice of reduction as two lines using procedure code T2025 (CONSUMER SUPPORT GRANT). Enter only one T2025 line for the county provider when a FSE is not used. Denial of CSGEnter CSG notice of denial as one line using procedure code T2025 (CONSUMER SUPPORT GRANT). | ||
MOD1-4 field | Tab past the four modifier fields. | ||
START/END DT fields | Enter the correct dates in MMDDYY format. Line start and end dates for CSG and FSE lines are the same as the AGMT START/END dates on the ASA1 screen. | ||
REQ TOT AMT field | Enter the requested dollar amount based on the CSG Budget Caps on the CSG and FSE lines. CSG with PCA assessmentMultiply the monthly CSG budget amount times the number of months on the line. Notice of reduction, notice of terminationMultiply the current (higher) monthly CSG budget amount times the number of months on the notice of reduction or termination line. Document the CSG monthly amount on the current SA on the AHC3 screen for DHS reviewer. Denial of CSGLeave the REQ TOT AMT field blank. CSG combined PCA and HCN or HHALeave the REQ TOT AMT field blank. DHS adds the correct dollar amount following the medical necessity review where the home care rating is determined. | ||
PROV NBR field | Enter the provider’s NPI (National Provider Index) number or the UMPI (Unique Minnesota Provider Index) number in the provider number field. Denial of CSGEnter the county provider number on the line for denial of CSG following an initial PCA assessment. Counties should use Provider Type 45 (County Human Service Agency), or 61 (County Public Health Nursing Org) provider number for CSG. Look up a provider number in MMIS1. Press function key F5 to navigate to the MMIS PROV RECIP KEY – CPRK screen. | ||
PROV NAME field | Leave the PROV NAME field blank. MMIS auto-populates this field based on the provider number entered after F9 key is used. | ||
RSN CD field | Enter up to 3 reason code(s) when appropriate. Enter the appropriate reason code to trigger MMIS to add legal notice language to the service agreement letters for notice of reduction, termination or denial of CSG. View reason code text in MMISMMIS adds text associated with a reason code to the service agreement letters. 1. Enter a reason code (three-digit number) in the RSN CD field. | ||
Navigation | Press function key F11 to display the next blank line when FSG line is the third line on the SA or press a transmit key to advance to the AHC1 screen. | ||
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