Last updated 11/22/2024
Live Video
POLICY
Medical assistance covers medically necessary services and consultations delivered by a health care provider through telehealth in the same manner as if the service or consultation was delivered through in-person contact. Services or consultations delivered through telehealth shall be paid at the full allowable rate.
SOURCE: MN Statute Sec. 256B.0625, Subdivision 3b(a). (Accessed Nov. 2024).
MHCP programs will cover telehealth services in the same manner as any other benefits covered through the programs. Coverage will not be limited on the basis of geography or location. Out-of-state coverage policy applies to services provided via telehealth.
SOURCE: MN Dept. of Human Services, Provider Manual, Telehealth Services, As revised Jun. 2, 2023. (Accessed Nov. 2024).
Minnesota’s Medical Assistance program reimburses live video for fee-for-service programs.
Providers must self-attest that they meet all of the conditions of the MHCP telehealth policy by completing and submitting the Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible for reimbursement.
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024. (Accessed Nov. 2024).
ELIGIBLE SERVICES/SPECIALTIES
MHCP programs will cover telehealth services in the same manner as any other benefits covered through the programs. Coverage will not be limited on the basis of geography or location. Out-of-state coverage policy applies to services provided via telehealth.
SOURCE: MN Dept. of Human Services, Provider Manual, Telehealth Services, As revised Jun. 2, 2023. (Accessed Nov. 2024).
The CPT and HCPC codes that describe a telehealth service are generally the same codes that describe an encounter when the health care provider and patient are at the same site. Examples of eligible services:
- Consultations
- Telehealth consults: emergency department or initial inpatient care
- Subsequent hospital care services with the limitation of one telehealth visit every 30 days per eligible provider
- Subsequent nursing facility care services with the limitation of one telehealth visit every 30 days
- End-stage renal disease services
- Individual and group medical nutrition therapy
- Individual and group diabetes self-management training with a minimum of one hour of in-person instruction to be furnished in the initial year training period to ensure effective injection training
- Smoking cessation [in telehealth services manual only]
- Alcohol and substance abuse (other than tobacco) structured assessment and intervention services
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024 & Telehealth Services, As revised Jun. 2, 2023. (Accessed Nov. 2024).
Telehealth does not include:
Non-covered services:
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2023, (Accessed Nov. 2024).
Two-way interactive video consultation in an emergency department (ED)
Two-way interactive video consultation may be billed when no physician is in the ED and the nursing staff is caring for the patient at the originating site. The ED physician at the distant site bills the ED CPT codes with place of service 02. Nursing services at the originating site would be included in the ED facility code. If the ED physician requests the opinion or advice of a specialty physician at a “hub” site, the ED physician bills the ED CPT codes and the consulting physician bills the consultation E/M code with place of service 02.
SOURCE: MN Dept of Human Services, Telehealth Services Manual, Jun. 2, 2023. (Accessed Nov. 2024).
Mental Health Services
Subject to federal approval, mental health services that are otherwise covered by medical assistance as direct face-to-face services may be provided via telehealth in accordance with subdivision 3b.
SOURCE: MN Statute Sec. 256B.0625, Subd. 46. (Accessed Nov. 2024).
MHCP members eligible for mental health services can receive mental health services delivered through telehealth.
Mental health services covered by medical assistance as direct face-to-face services may be provided via telehealth and are covered by MHCP. For mental health services or assessments delivered through telehealth that are based on an individual treatment plan, the provider may document the client’s verbal approval or electronic written approval of the treatment plan or change in the treatment plan in lieu of the client’s signature.
Authorization is required for mental health services delivered through telehealth if authorization is required for the same service through in-person contact.
SOURCE: MN Dept. of Human Services, Provider Manual, Telehealth Delivery of Mental Health Services, Revised Oct. 17, 2022, (Accessed Nov. 2024).
Assertive Community Treatment and Intensive Residential Treatment Services
Physician services that are not separately billed may be included in the rate to the extent that a psychiatrist, or other health care professional providing physician services within their scope of practice, is a member of the intensive residential treatment services treatment team. Physician services, whether billed separately or included in the rate, may be delivered by telehealth.
SOURCE: MN Statute Sec 256B.0622, subdivision 8(e), (Accessed Nov. 2024).
Individualized Education Program (IEP)
Telehealth coverage applies to a child or youth who is MA eligible, has an IEP and the service provided is identified in the IEP.
To be eligible for reimbursement, the school or school district must self-attest by completing the Provider Assurance Statement for Telehealth (DHS-6806) (PDF) that the telehealth services are provided by a qualified professional provider, either employed by or contracted by the school, who meets all of the conditions of the MHCP telehealth policy.
MHCP covers these services for telehealth:
- Physical therapy
- Occupational therapy
- Speech language therapy services
Schools that provide mental health service through the Children’s Therapeutic Services and Suports program (CTSS) should follow CTSS telehealth policies. For more information, review the IEP Mental Health Services manual section and the Children’s Therapeutic Services and Supports webpage.
Non-Covered Services:
- IEP nursing services
- Special transportation
- Assistive technology
- Personal care assistance (PCA) services
MHCP telehealth coverage will not pay the following:
- Electronic connections that are conducted over a website that is not secure and encrypted as specified by the Health Insurance Portability and Accountability Act of 1996 privacy and security rules (for example, Skype)
- IEP evaluations assessments and services that are less effective if provided in person, or require hands on, face-to-face contact
- Prescription renewals, refills, obtaining orders from a primary care provider
- Scheduling a test or appointment
- Non-clinical communication
- Communication via telephone, email or fax
Use the same HCPC codes and modifiers that describe the IEP services being performed via telehealth as you would if the service was being provided in person with the child at the same site.
IEP Telehealth Place of Service Codes:
Originating site
- Use place of service 10 on claims to indicate when the child receives the health-related service via telecommunication technology in the child’s home. This is a location other than a hospital or other facility where the child receives care in a private residence.
Distant site
- Use place of service 02 on claims to indicate when the child receives the health-related service via telecommunication technology when the child is in a location other than a child’s home.
SOURCE: MN Dept. of Human Svcs., Provider Manual, IEP Services, Revised May 19, 2022, (Accessed Nov. 2024).
Providers may deliver some SUD services via telehealth. Review the Telehealth Delivery of Substance Use Disorder Services section of the MHCP Provider Manual for more information.
SOURCE: MN Dept. of Human Services, Provider Manual, Substance Use Disorder (SUD) Services, Sept. 2024, (Accessed Nov. 2024).
The following medically necessary substance use disorder (SUD) services provided by eligible SUD providers via telehealth are covered:
- Comprehensive assessments
- Individual and group treatment services
- Peer recovery support services
See the Telehealth Services section of the MHCP Provider Manual for noncovered telehealth services.
SOURCE: Substance Use Disorder Telehealth, May 23, 2023, (Accessed Nov. 2024).
Child Welfare Targeted Case Management (CW-TCM)
Case management activities are those that help the eligible member gain access to needed medical, social, educational and other services as identified in an individual service plan. Only services delivered on a face-to-face or interactive video basis are claimable as CW-TCM unless the client is in placement more than 60 miles beyond county or reservation boundaries. If a client is in placement more than 60 miles beyond county or reservation boundaries, a provider may deliver services using telephone or interactive video contact for two consecutive months. There must be a face-to-face contact in the month before the eligible telephone or ITV contacts when children have been and continue to be in placement.
See manual for examples.
Interactive video means the delivery of targeted case management services in real time through the use of two-way interactive audio and visual communication, or accessible video-based platforms.
CW-TCM services may be provided through ITV according to Minnesota Statutes, 256B.0625, subdivision 20b and reimbursed according to Minnesota Statutes, 256B.094, subdivision 6. ITV or face-to-face contact meets the minimum face-to-face contact requirements for CW-TCM services with the exception of children in out-of-home placement or receiving case management for child protection reasons require an eligible in-person contact.
For children and youth in foster care for whom a responsible social service agency has placement and care responsibility, the contact must be seen in- person to claim targeted case management. Foster care is defined by Minnesota Statutes, 260C.007, subdivision 18 and 260D.02, subdivision 10.
Children receiving case management for child protection reasons must be seen in person.
Exception – if the child is placed more than 60 miles beyond the county or reservation boundaries, telephone contact or ITV, is claimable for up to two consecutive months and there must be face-to-face contact at least once every three months. Providers must have a Targeted Case Management Provider Interactive Video Assurance Statement (DHS-8398) on their provider file to provide services via ITV.
SOURCE: MN Dept. of Human Svcs., Child Welfare Targeted Case Management (CW-TCM), Jan. 11, 2024, (Accessed Nov. 2024).
Dental
Teledentistry is the delivery of dental care services or consultations while the patient is at an originating site and the dentist is at a distant site. MHCP allows payment for teledentistry services. Refer to Telehealth Services for more information. Reimbursement for teledentistry is the same as face-to-face encounters. The distant site can bill for the services provided by a licensed dentist. Affiliate practice or originator within Minnesota Board of Dentistry defined scope of practice must be present at originating site.
MHCP allows the following CDT codes for these diagnostic services when performed through teledentistry services:
- Periodic oral evaluation (with an established patient)
- Limited oral exam
- Oral evaluation for a patient under 3 years of age
- Comprehensive oral evaluation (new or established patient)
- Intraoral (complete series of radiographic images)
- Intraoral (periapical first radiographic image)
- Intraoral (periapical each additional radiographic image)
- Bitewing (single radiographic image)
- Bitewings (two radiographic images)
- Bitewings (four radiographic images)
- Intraoral—occlusal radiographic image
- Panoramic radiographic imaging
- Medical dental consultation
Limitations
- MHCP will pay for only one reading or interpretation of diagnostic tests such as X-rays, lab tests and diagnostic assessment.
- Payment is not available to providers for sending materials.
- Out-of-state coverage policy applies to services provided via teledentistry services
- Consultations performed by providers who are not located in Minnesota and contiguous counties require authorization prior to the service being provided.
SOURCE (Dental): MN Dept. of Human Svcs., Provider Manual, Dental Svcs. Jan. 16, 2024 (Accessed Nov. 2024).
Early Intensive Developmental and Behavioral Intervention (EIDBI) services
Telehealth is an option for certain Early Intensive Developmental and Behavioral Intervention (EIDBI) services.
SOURCE: MN Dept. of Human Svcs., EIDBI Services Benefits billing grid, updated July 2024 & MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services. 8/6/24. (Accessed Nov. 2024).
The following EIDBI services may be billed without the member present:
- Comprehensive Multi-Disciplinary Evaluation (CMDE)
- Individualized Treatment Plan (ITP)
- Family/Caregiver Training and Counseling
- Coordinated Care Conference
- Travel time
See grid for more information.
SOURCE: MN Dept. of Human Svcs., EIDBI Services Benefits billing grid, updated June 2024, (Accessed Nov. 2024).
Medical Assistance (MA) covers medically necessary telehealth services and consultations. The telehealth services and consultations must be provided with the same service thresholds, authorization requirements and reimbursement rates as services delivered in person.
Because the Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit is available under MA, telehealth is an option for some EIDBI services. For additional telehealth requirements, refer to MHCP Provider Manual – Telehealth services.
For information about the Telehealth for Early Intervention training, refer to EIDBI – Individual provider trainings.
An eligible EIDBI provider may deliver the following EIDBI services via telehealth:
- CMDE.
- Coordinated care conference.
- Family/caregiver training and counseling.
- Individual treatment plan (ITP) development and progress monitoring.
- Intervention – group and individual only (higher intensity intervention sessions cannot occur via telehealth).
- Observation and direction.
EIDBI telehealth services do not cover:
- Connection charges.
- Origination, set-up or site fees.
- Communication between health care providers that consists solely of email or fax transmission (i.e., a copy of written or printed material).
- Communication between a person and health care provider that consists solely of email or fax transmission (i.e., a copy of written or printed material).
- Higher intensity intervention sessions.
EIDBI telehealth services must be:
- Compliant with industry interoperable standards (i.e., ability for systems and organizations to share data and information).
- Compliant with Health Insurance Portability and Accountability Act (HIPAA) privacy and security requirements and regulations.
- Medically necessary for the person and/or family.
For additional telehealth provider requirements, refer to MHCP Provider Manual – Physician and professional services – Telehealth.
Providers must deliver EIDBI telehealth services with the same service thresholds, authorization requirements and reimbursement rates as services delivered in person.
SOURCE: MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services. 8/6/24. (Accessed Nov. 2024).
Medical assistance covers medically necessary EIDBI services and consultations delivered via telehealth, as defined under section 256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered in person.
SOURCE: MN Statute Sec. 256B.0949, Subdivision. 13. (Accessed Nov. 2024).
Rehabilitation Services
The CPT and HCPCS codes that describe a telehealth services are generally the same codes that describe an encounter when the health care provider and patient are at the same site.
Physical and occupational therapists, speech-language pathologists and audiologists may use telehealth to deliver certain covered rehabilitation therapy services that they can appropriately deliver via telehealth. Service delivered by this method must meet all other rehabilitation therapy service requirements and providers must adhere to the same standards and ethics as they would if the service was provided face to face.
MHCP-enrolled providers submit claims for telehealth services using the CPT or HCPCS code that describes the services they provide.
When submitting claims for telehealth services, use place-of-service code 02 to certify that the services meets the telehealth requirements. The GQ modifier is required when billing for services via asynchronous telecommunication systems.
The following limitations apply:
- Payment for telehealth services is limited to three sessions per week per member
- Payment is not available for sending materials to a member, other providers or other facilities
MHCP does not cover the following under telehealth:
- Electronic connections that are not conducted over a secure encrypted website as specified by HIPAA
- Scheduling a test or appointment
- Clarification of issues from a previous visit
- Reporting test results
- Non-clinical communication
- Communication via telephone, email or fax
See manual for documentation requirements.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Jan. 25, 2022 (Accessed Nov. 2024).
Medication Therapy Management Services (MTMS)
Medication therapy management services include the following: …
Face-to-face or telehealth encounters done in any of the following:
- Ambulatory care outpatient setting
- Clinics
- Pharmacies
MTMS services delivered by telehealth must meet all state and federal requirements for equipment, privacy and billing, including the following:
- Telehealth systems must be compliant with HIPAA privacy and security requirements and regulations.
- Billing providers must submit claims with the applicable MTMS codes and telehealth (telemedicine) identifiers to signify that the service was delivered by telehealth. Billing requirements for telehealth (telemedicine) services are described in the Physician and Professional Services section of the MHCP Provider Manual.
- Providers must submit the Telemedicine Provider Assurance Statement (DHS-6806) (PDF) before billing for telehealth MTMS encounters.
Non Covered Services
- Encounters in the inpatient setting
- Encounters in skilled nursing facilities
- Encounters for MTMS for dual-eligible members
MHCP will reimburse pharmacies, clinics and hospitals for MTMS only for face-to-face or telehealth encounters on the lowest of five patient need levels, according to the following qualifying criteria:
- The number of medications the patient is currently taking (drug combination products are counted as one medication)
- The number of drug therapy problems the patient has at present
- The number of medical conditions for which the patient is currently being treated
SOURCE: MN Dept. of Human Svcs., Provider Manual, Medication Therapy Management Svcs. Nov. 3, 2021 (Accessed Nov. 2024).
Medication therapy management services may be provided via telehealth as defined in subdivision 3b and may be delivered into a patient’s residence. Reimbursement shall be at the same rates and under the same conditions that would otherwise apply to the services provided. To qualify for reimbursement under this paragraph, the pharmacist providing the services must meet the requirements of paragraph (b).
SOURCE: 256B.0625(Subd)(13h)(d), (Accessed Nov. 2024).
Behavioral Health Home Services
If an member accepts the offer for a face-to-face visit at six months, providers who are eligible to provide services via telehealth may do so. Providers must have a valid Telehealth Provider Assurance Statement (DHS-6806) (PDF) on file with DHS and must comply with all MA telehealth requirements for equipment, privacy and billing to serve individuals receiving BHH services through telehealth. Refer to the following sections for requirements, billing and additional information:
- Telehealth subsection of the Physician and Professional Services MHCP Provider Manual section
- Telehealth Delivery of Mental Health Services
SOURCE: MN Department of Human Services, Behavioral Health Home Services, Sept. 13, 2024. (Accessed Nov. 2024).
Targeted Case Management
Interactive video means the delivery of targeted case management services in real time through the use of two-way interactive audio and visual communication, or accessible video-based platforms.
MH-TCM services may be provided through ITV according to Minnesota Statutes 256B.0625, subdivision 20b. ITV or face-to-face contact meets the minimum face-to-face contact requirements for MH-TCM services with the exception of children in out-of-home placement who require an in-person or face-to-face visit only.
Children and youth in foster care for whom a responsible social service agency has placement and care responsibility, must be seen in person to claim targeted case management. Foster care is defined by Minnesota Statutes 260C.007, subdivision 18 and 260D.02, subdivision 10.
Providers must have a Targeted Case Management Provider Interactive Video Assurance Statement (DHS-8398) (PDF) on their provider file to provide services via ITV.
SOURCE: MN Dept. of Human Services, Adult Mental Health Targeted Case Management and Children’s Mental Health Targeted Case Management, Nov. 13. 2023 (Accessed Nov. 2024).
Screening, Brief Intervention, and Referral to Treatment (SBIRT)
Providers must have documentation of services provided and have followed all clinical standards to bill for services via telehealth or telephonic (audio-only) telehealth. Refer to the Telehealth Services section of the MHCP Provider Manual under Billing for information about billing for services provided via telehealth.
SOURCE: MN Dept. of Human Services, Screening, Brief Intervention and Referral to Treatment, Dec. 29, 2022 (Accessed Nov. 2024).
Services provided by a school-based health center may include but are not limited to…
- emerging services such as mobile health and telehealth.
SOURCE: MN Statute, Sec. 145.903, (Accessed Nov. 2024).
Doula Services
A telehealth labor and delivery doula visit can be billed if the member’s needs were met by the doula during the labor and delivery process; and the doula was available to the member with no other commitments throughout the entirety of the labor and delivery process by telephone or video conference.
If the doula was unavailable during the entirety of the labor and delivery process but was able to provide key support during some of the labor and delivery, they may bill for a non-labor and delivery visit for their time spent with the member.
Providers must submit a completed and signed Telehealth Provider Assurance Statement (DHS-6806) (PDF) to the Minnesota Department of Human Services to bill for telehealth services. Review Telehealth Services in the MHCP Provider Manual for additional details.
SOURCE: MN Dept of Human Services, Doula Services, Apr. 19, 2024, (Accessed Nov. 2024).
Reproductive Services
Telehealth services are covered for MHCP members.
Certain specific services are not covered. See applicable section.
SOURCE: MN Dept of Human Services, Reproductive Health/OB-GYN, Apr. 1, 2024, & Free-Standing Birth Center Services, Mar. 13, 2024, (Accessed Nov. 2024).
Telehealth services are covered for MHCP members. Providers must submit a completed and signed Telehealth Provider Assurance Statement (DHS-6806) (PDF) to the Minnesota Department of Human Services to bill for telehealth services. Review Telehealth Services in the MHCP Provider Manual for more information.
SOURCE: MN Dept of Human Services, Obstetrics, Apr. 26, 2024, & Family Planning, Apr. 1, 2024, (Accessed Nov. 2024).
Federally Qualified Health Center and Rural Health Clinic
Face-to-face includes telehealth services provided by an eligible provider.
SOURCE: MN Dept of Human Services, Federally Qualified Health Center and Rural Health Clinic, Mar. 18, 2024, (Accessed Nov. 2024).
Remote Reassessments
Assessments performed according to subdivisions 17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the requirements of this subdivision. Remote reassessments conducted by interactive video or telephone may substitute for in-person reassessments.
For services provided by the developmental disabilities waiver under section 256B.092, and the community access for disability inclusion, community alternative care, and brain injury waiver programs under section 256B.49, remote reassessments may be substituted for two consecutive reassessments if followed by an in-person reassessment.
For services provided by alternative care under section 256B.0913, essential community supports under section 256B.0922, and the elderly waiver under chapter 256S, remote reassessments may be substituted for one reassessment if followed by an in-person reassessment.
For personal care assistance provided under section 256B.0659 and community first services and supports provided under section 256B.85, remote reassessments may be substituted for two consecutive reassessments if followed by an in-person reassessment.
A remote reassessment is permitted only if the lead agency provides informed choice and the person being reassessed or the person’s legal representative provides informed consent for a remote assessment. Lead agencies must document that informed choice was offered.
The person being reassessed, or the person’s legal representative, may refuse a remote reassessment at any time.
During a remote reassessment, if the certified assessor determines an in-person reassessment is necessary in order to complete the assessment, the lead agency shall schedule an in-person reassessment.
All other requirements of an in-person reassessment apply to a remote reassessment, including updates to a person’s support plan.
SOURCE: MN Statute Sec. 256B.0911 & Senate File 4399 (2024 Session), (Accessed Nov. 2024).
Worker training and development services; remote visits
Except as provided in paragraph (b), the worker training and development services specified in subdivision 18a, paragraph (c), clauses (3) and (4), may be provided to recipients with chronic health conditions or severely compromised immune systems via two-way interactive audio and visual telecommunications if, at the recipient’s request, the recipient’s primary health care provider:
- determines that remote worker training and development services are appropriate; and
- documents the determination under clause (1) in a statement of need or other document that is subsequently included in the recipient’s CFSS service delivery plan.
The worker training and development services specified in subdivision 18a, paragraph (c), clause (3), provided at the start of services or the start of employment of a new support worker must not be conducted via two-way interactive audio and visual telecommunications.
Notwithstanding any other provision of law, a CFSS service delivery plan developed or amended via remote worker training and development services may be executed by electronic signature.
A recipient may request to return to in-person worker training and development services at any time.
SOURCE: MN Statute Sec. 256B.85 & Senate File 4399 (2024 Session), (Accessed Nov. 2024).
Substance Use Disorder
Subject to federal approval, substance use disorder services that are otherwise covered as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, subdivision 3b. The use of telehealth to deliver services must be medically appropriate to the condition and needs of the person being served. Reimbursement shall be at the same rates and under the same conditions that would otherwise apply to direct face-to-face services.
SOURCE: MN Statute Sec. 254B.05 & Senate File 4399 (2024 Session), (Accessed Nov. 2024).
“Direct service time” means the time that a mental health professional, clinical trainee, mental health practitioner, or mental health behavioral aide spends face-to-face with a client and the client’s family or providing covered services through telehealth as defined under section 256B.0625, subdivision 3b. Direct service time includes time in which the provider obtains a client’s history, develops a client’s treatment plan, records individual treatment outcomes, or provides service components of children’s therapeutic services and supports. Direct service time does not include time doing work before and after providing direct services, including scheduling or maintaining clinical records.
SOURCE: MN Statute Sec. 256B.0943 & House File 4483 (2024 Session), (Accessed Nov. 2024).
Durable Medical Equipment
Face-to-face encounters may occur through telehealth. Review Medicaid’s Telehealth webpage for more information.
SOURCE: MN Dept. of Human Services, Equipment & Supplies, Oct. 2, 2024. (Accessed Nov. 2024).
Vaccine Counseling
Effective Jan. 1, 2022, MHCP covers vaccine counseling. Providers may counsel for COVID-19 vaccinations and standard vaccines. Counseling may be provided both in-person and through telehealth. Providers billing for vaccine counseling services must have the ability to administer the vaccine for which they are counseling. Providers cannot bill for vaccine counseling separately if the counseling is a required component of another service provided in the same visit.
SOURCE: MN Dept. of Human Services, Immunizations and Vaccinations, Jan. 31, 2024. Child and Teen Checkups (C&TC), Oct. 30, 2023. (Accessed Nov. 2024).
Community Paramedic
Telehealth vists are covered when they are medically appropriate and adhere to the requirements of our telehealth policy.
SOURCE: MN Dept. of Human Services, Community Paramedic Services Sept. 25, 2023. (Accessed Nov. 2024).
ELIGIBLE PROVIDERS
Distant site
Site at which the health care provider is located while providing health care services or consultations by means of telehealth, which can include the provider’s home.
Providers must self-attest that they meet all of the conditions of the Minnesota Health Care Programs (MHCP) telehealth policy by completing and submitting a Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible for reimbursement.
MHCP covers medically necessary services and consultations delivered by a health care provider through telehealth. A health care provider means a health care professional who is licensed or registered by the state to perform health care services within the provider’s scope of practice according to state law.
SOURCE: MN Dept. of Human Services, Telehealth Services Manual, Jun. 2, 2023. (Accessed Nov. 2024).
Providers must self-attest that they meet all of the conditions of the MHCP telehealth policy by completing and submitting the Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible for reimbursement. The following provider types are eligible to provide telehealth services:
- Physician
- Nurse practitioner
- Physician assistant
- Nurse midwife
- Clinical nurse specialist
- Registered dietitian or nutrition professional
- Dentist, dental hygienist, dental therapist, advanced dental therapist
- Mental health professional, when following the requirements and service limitations listed in the Telehealth Delivery of Mental Health Services section.
- Pharmacist
- Certified genetic counselor
- Podiatrist
- Speech therapist
- Physical therapist
- Occupational therapist
- Audiologist
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024, (Accessed Nov. 2024).
Medical assistance covers medically necessary services and consultations delivered by a health care provider through telehealth in the same manner as if the service or consultation was delivered through in-person contact. Services or consultations delivered through telehealth shall be paid at the full allowable rate.
“health care provider” means a health care provider as defined under section 62A.673; a community paramedic as defined under section 144E.001, subdivision 5f; a community health worker who meets the criteria under subdivision 49, paragraph (a); a mental health certified peer specialist under section 245I.04, subdivision 10; a mental health certified family peer specialist under section 245I.04, subdivision 12; a mental health rehabilitation worker under section 245I.04, subdivision 14; a mental health behavioral aide under section 245I.04, subdivision 16; a treatment coordinator under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11, subdivision 5; or a recovery peer under section 245G.11, subdivision 8
Telehealth visits provided through audio and visual communication or accessible video-based platforms may be used to satisfy the face-to-face requirement for reimbursement under the payment methods that apply to a federally qualified health center, rural health clinic, Indian health service, 638 tribal clinic, and certified community behavioral health clinic, if the service would have otherwise qualified for payment if performed in person.
SOURCE: MN Statute Sec. 256B.0625, Subd. 3b(d). (Accessed Nov. 2024).
Individualized Education Program (IEP)
Use place of service 02 on claims to indicate when the child receives the health-related service via telecommunication technology when the child is in a location other than a child’s home.
Eligible providers include the following:
- Charter schools
- Education districts
- Intermediate districts
- Public school districts
- Tribal schools (schools that receive funding from the Bureau of Indian Affairs-BIA)
- Service cooperatives
- Special education cooperatives
- State academies
SOURCE: MN Dept. of Human Svcs., Provider Manual, IEP Services, Revised May 19, 2022. (Accessed Nov. 2024).
Early Intensive Developmental and Behavioral Intervention (EIDBI) services
Eligible providers include health care professionals who are licensed or registered by the state to perform health care services within the provider’s scope of practice and in accordance with state law. Eligible providers are defined as:
- Mental health professionals (as defined under Minn. Stat. §245.462, subd. 18 or Minn. Stat. §245.4871, subd. 27).
- Mental health practitioners (as defined by Minn. Stat. §245.462, subd. 17 or Minn. Stat. §245.4871, subd. 26) working under the general supervision of a mental health professional.
Comprehensive multi-disciplinary evaluation (CMDE) providers, qualified supervising professionals (QSPs), level I and some level II providers may meet the requirements outlined above and may apply to provide EIDBI services via telehealth.
SOURCE: MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services. 8/6/24. (Accessed Nov. 2024).
All enrolled EIDBI individual providers that qualify and plan to deliver telehealth services must self-attest that they meet all conditions of the MHCP telehealth policy. Review the telehealth criteria on the EIDBI telehealth services webpage.
Level III EIDBI providers do not qualify to provide services via telehealth.
Individual providers should complete and submit the Provider Assurance Statement for Telehealth (DHS-6806) (PDF) to DHS through the MPSE portal or by fax to add telehealth services to your current enrollment record.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Enrollment Criteria and Forms, Revised Feb. 23, 2024. (Accessed Nov. 2024).
Mental Health Services
Eligible providers include any of the following:
- Mental health professionals who are qualified under Minnesota Statute 2451.04
- Mental health practitioners working under the supervision of a mental health professional
- Mental health certified peer specialists
- Mental health certified family peer specialists
- Mental health rehabilitation workers
- Mental health behavioral aides
- Clinical trainees
Providers must self-attest that they meet all of the conditions of the MHCP telehealth policy by completing and submitting a Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible to provide and be reimbursed for services provided via telehealth.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Telehealth Delivery of Mental Health Services, Revised Oct. 17, 2022 (Accessed Nov. 2024).
Providers currently authorized to provide services may conduct the same services via telehealth. Providers must self-attest that they meet all of the conditions of the MHCP telehealth policy by completing and submitting the Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible to provide and be reimbursed for services via telehealth.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Substance Use Disorder Telehealth, May 23, 2023 (Accessed Nov. 2024).
Targeted Case Management (TCM)
The following MHCP-enrolled TCM providers may deliver TCM through interactive video:
- Child Welfare Targeted Case Management
- Children’s Mental Health Targeted Case Management
- Adult Mental Health Targeted Case Management
- Vulnerable Adult/Developmental Disability Targeted Case Management
Organizational providers who want to deliver and bill for TCM services using interactive video must assure they meet the requirements of the interactive video policy and attest to the safety and effectiveness of interactive video for the person served, according to Minnesota Statutes, 256B.0625, subdivision 20b. Complete and submit the Targeted Case Management Provider Interactive Video Assurance Statement (DHS-8398) (PDF) to DHS through the MPSE portal or by fax to add interactive video services to your current enrollment record.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Targeted Case Management (TCM) Enrollment Criteria and Forms, Feb. 29, 2024 (Accessed Nov. 2024).
Rehabilitation Services
The following provider types are eligible to provide telehealth services:
- Speech-language pathologists
- Physical therapists
- Physical therapist assistants
- Occupational therapists
- Occupational therapy assistants
- Audiologists
Physical therapist assistants and occupational therapy assistants providing services via telehealth must follow the same supervision policy as indicated in “Rehabilitation Service Practitioners”.
The distant site is the location of the health care provider at the time the provider is delivering the service to an eligible MHCP member via telecommunication system. There are no specific authorized distant sites or restrictions, but providers must ensure a secure transmission that meets Health Insurance Portability & Accountability Act of 1996 Privacy and Security (HIPAA) requirements.
To be eligible for reimbursement, providers must self-attest that they meet all of the conditions of the MHCP telehealth policy by completing the Provider Assurance Statement for Telehealth (DHS-6806) (PDF). This includes individually enrolled private-practice therapists and enrolled therapists working within a rehabilitation billing entity that submit claims on the 837P Professional claim type.
When submitting claims for telehealth services, use place-of-service code 02 to certify that the services meets the telehealth requirements. The GQ modifier is required when billing for services via asynchronous telecommunication systems.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Jan. 25, 2022. (Accessed Nov. 2024).
Dental
Eligible providers
- Dentist
- Advanced dental therapists
- Dental therapists
- Dental hygienists
- Licensed dental assistants
- Other licensed health care professionals
SOURCE: MN Dept. of Human Svcs., Provider Manual, Dental Svcs. Jan. 16, 2024. (Accessed Nov. 2024).
Medical Assistance Services and Payment Rates
Telehealth visits provided through audio and visual communication or accessible video-based platforms may be used to satisfy the face-to-face requirement for reimbursement under the payment methods that apply to a federally qualified health center, rural health clinic, Indian health service, 638 tribal clinic, and certified community behavioral health clinic, if the service would have otherwise qualified for payment if performed in person.
SOURCE: MN Statute 256B.0625, Subd. 3b, Sec. 7(d). (Accessed Nov. 2024).
Doula Services
A telehealth labor and delivery doula visit can be billed if the member’s needs were met by the doula during the labor and delivery process; and the doula was available to the member with no other commitments throughout the entirety of the labor and delivery process by telephone or video conference.
If the doula was unavailable during the entirety of the labor and delivery process but was able to provide key support during some of the labor and delivery, they may bill for a non-labor and delivery visit for their time spent with the member.
Providers must submit a completed and signed Telehealth Provider Assurance Statement (DHS-6806) (PDF) to the Minnesota Department of Human Services to bill for telehealth services. Review Telehealth Services in the MHCP Provider Manual for additional details.
SOURCE: MN Dept of Human Services, Doula Services, Jan. 12, 2024, (Accessed Nov. 2024).
Reproductive Services
Providers must submit a completed and signed Telehealth Provider Assurance Statement (DHS-6806) (PDF) to the Minnesota Department of Human Services to bill for telehealth services. Review Telehealth Services in the MHCP Provider Manual for more information.
SOURCE: MN Dept of Human Services, Reproductive Health/OB-GYN, Apr. 1, 2024; Free-Standing Birth Center Services, Mar. 13, 2024; MN Family Planning Program (MFPP), Mar. 12, 2024; Abortion Services, Feb. 27, 2024, (Accessed Nov. 2024).
Federally Qualified Health Center and Rural Health Clinic
Face-to-face includes telehealth services provided by an eligible provider.
SOURCE: SOURCE: MN Dept of Human Services, Federally Qualified Health Center and Rural Health Clinic, Mar. 18, 2024,(Accessed Nov. 2024).
ELIGIBLE SITES
The site at which the member is located at the time health care services are provided to them by means of telehealth, which can include the member’s home.
Providers who have an approved Telehealth Provider Assurance Statement (DHS-6806) (PDF) on file with MHCP who submit professional claims for services via telehealth should use claim format MN-ITS 837P (professional), CPT or HCPCS codes that describes the services rendered and with a required place of service 02 or new place of service 10 for services via telehealth. Include the 93 modifier when billing for services provided via audio only (telephone communication).
- Place of service 02 newly defined: Telehealth provided other than the patient’s home. The location where health services and health-related services are provided or received through telecommunication technology. The patient is not located in their home when receiving health services or health-related services through telecommunication technology.
- Place of service 10: Telehealth provided in patient’s home. The location where health services and health-related services are provided or received through telecommunication technology. The patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
- Modifier 93 Audio only: Synchronous telehealth service rendered via telephone or other real-time interactive audio-only telecommunications system. MHCP requires modifier 93 when audio-only telehealth is used.
Outpatient facilities (Ambulatory Payment Classifications or Ambulatory Surgical Center claims) will continue to use telehealth modifiers on their claims.
Providers who service SUD H2035/HQ on type of bill 89X should continue to use telehealth modifiers on their claims.
SOURCE: MN Dept. of Human Services, Telehealth Services Manual, Jun. 2, 2023. (Accessed Nov. 2024).
Physician and Professional Services
Providers should have a Telehealth Provider Assurance Statement (DHS-6806) (PDF) on their provider file to bill claims for services provided via telehealth. Providers who submit professional claims for services via telehealth should use claim format 837P (professional), including the CPT or HCPCS code that describes the services rendered and the place of service 02 or new place of service 10 for services via telehealth. Include the 93 modifier when billing for services provided via audio only (telephone communication).
Place of service 02 (newly redefined): Telehealth provided other than the member’s home. It’s the location where health services and health-related services are provided or received through telecommunication technology. The member is not located in their home when receiving health services or health-related service through telecommunication technology.
Place of service 10 (new place of service): Telehealth provided in member’s home. The location where health services and health-related services are provided or received through telecommunication technology. Member is located in their home (which is a location other than a hospital or other facility where the member receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
When reporting a service with place of service 02 or 10, you are certifying that you are rendering services to a member located in an eligible originating site via an interactive audio and visual telecommunications system.
Modifier 93, Audio only: Synchronous telehealth service rendered via telephone or other real-time interactive audio-only telecommunications system. MHCP requires this modifier when audio-only telehealth is used.
All other telehealth modifiers: All the other telehealth modifiers (GT, GQ, GO, 95) can be used for informational purposes but will not be required. The telehealth place of service codes explain that the service is rendered through telehealth. No telehealth modifiers can be used without place of service 02 or 10 or the claim will deny.
MHCP does not pay an originating site facility fee. Services billed on an outpatient claim with the GQ modifier will pay zero.
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024, (Accessed Nov. 2024).
Mental Health Delivery
Providers should have a Telehealth Provider Assurance Statement (DHS-6806) (PDF) on their provider file beginning June 1, 2022, to bill claims for services provided via telehealth. Providers must have documentation of services provided and must have followed all clinical standards to bill for telehealth.
Place of service 02 (newly redefined): Telehealth provided other than the patient’s home. It’s the location where health services and health-related services are provided or received through telecommunication technology. The patient is not located in their home when receiving health services or health-related service through telecommunication technology.
Place of service 10 (new place of service): Telehealth provided in patient’s home. The location where health services and health-related services are provided or received through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
When reporting a service with place of service 02 or 10, you are certifying that you are rendering services to a patient located in an eligible originating site via an interactive audio and visual telecommunications system.
Modifier 93, Audio only: Synchronous telehealth service rendered via telephone or other real-time interactive audio-only telecommunications system. MHCP requires this modifier when audio-only telehealth is used.
All other telehealth modifiers: All the other telehealth modifiers (GT, GQ, GO, 95) can be used for informational purposes but will not be required. The telehealth place of service codes explain that the service is rendered through telehealth. No telehealth modifiers can be used without place of service 02 or 10 or the claim will deny.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Telehealth Delivery of Mental Health Services, Revised Oct. 17, 2022 (Accessed Nov. 2024)
Individualized Education Program (IEP)
Use place of service 10 on claims to indicate when the child receives the health-related service via telecommunication technology in the child’s home. This is a location other than a hospital or other facility where the child receives care in a private residence.
Use place of service 02 on claims to indicate when the child receives the health-related service via telecommunication technology when the child is in a location other than a child’s home.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Individualized Education Program, May 19, 2022 (Accessed Nov. 2024)
02 – Telehealth provided other than in the child’s home. The child is not located in their home when receiving health services or health-related services through telecommunication technology.
10 – Telehealth provided in the child’s home. The child is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
SOURCE: MN Dept. of Human Svcs., Provider Manual, IEP Billing and Authorization Requirements, Oct. 15, 2024 (Accessed Nov. 2024).
Medication Therapy Management Services (MTMS)
Medication therapy management services include the following:
- Face-to-face or telehealth encounters done in any of the following:
- Ambulatory care outpatient setting
- Clinics
- Pharmacies
- Member’s home or place of residence if the member does not reside in a skilled nursing facility
See manual for privacy, equipment and reimbursement requirements.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Medication Therapy Management Svcs. Nov. 3, 2021 (Accessed Nov. 2024).
Telehealth Delivery of Substance Use Disorder Services
MHCP allows payment for telehealth services in substance use disorder treatment for services that are otherwise covered as direct face-to-face services.
Place of service 02 (newly defined): Telehealth provided other than the patient’s home. The location where health services and health-related services are provided or received through telecommunication technology. The patient is not located in their home when receiving health services or health-related services through telecommunication technology.
Place of service 10 (new place of service): Telehealth provided in patient’s home. The location where health services and health-related services are provided or received through telecommunication technology. The patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Substance Use Disorder Telehealth, May 23, 2023, (Accessed Nov. 2024).
Dental
Affiliate practice or originator within Minnesota Board of Dentistry defined scope of practice must be present at originating site.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Dental Svcs. Jan. 16, 2024. (Accessed Nov. 2024).
Rehabilitation Services
Eligible originating sites:
- Office of physician or practitioner
- Hospital (inpatient or outpatient)
- Critical access hospital (CAH)
- Rural health clinic (RHC) and Federally Qualified Health Center (FQHC)
- Hospital-based or CAH-based renal dialysis center (including satellites)
- Skilled nursing facility (SNF)
- End-stage renal disease (ESRD) facilities
- Community mental health center
- Dental clinic
- Residential facilities, such as a group home and assisted living
- Home (a licensed or certified health care provider may need to be present to facilitate the delivery of telehealth services provided in a private home)
- School
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Jan. 25, 2022. (Accessed Nov. 2024).
Outpatient Services of Tribal Facilities
MA-covered services provided through tribal facilities may be paid at either the IHS encounter rate or the applicable fee-for-service rate. Tribes may choose either payment rate for each separate 638 facility. All services of a single facility will be paid at the chosen rate. Service categories eligible for reimbursement at the IHS outpatient reimbursement rate are: …
An encounter for a tribal or IHS facility means a face-to-face visit between a member eligible for MA and any health professional at or through an IHS or tribal service location for the provision of MA covered services within a 24-hour period ending at midnight.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Tribal and Federal Indian Health Svcs., September 9, 2021 (Accessed Nov. 2024).
Targeted Case Management
When services have been delivered via ITV, the appropriate place of service must be provided.
- Place of service 02: ITV contact provided other than the client’s home. The client is not located in their home when receiving MH-TCM service through ITV.
- Place of service 10: ITV contact provided in the client’s home. The client is located in their home when receiving MH-TCM service through ITV.
MHCP does not reimburse for connection charges, or origination, set-up or site fees.
SOURCE: MN Dept. of Human Services, Adult Mental Health Targeted Case Management and Children’s Mental Health Targeted Case Management, Nov. 13. 2023 (Accessed Nov. 2024).
GEOGRAPHIC LIMITS
Child Welfare Targeted Case Management (CW-TCM)
Interactive video (ITV) may be means of delivery of targeted case management services. However, if the child is placed more than 60 miles beyond the county or reservation boundaries, telephone contact or ITV, is claimable for up to two consecutive months and there must be face-to-face contact at least once every three months. Providers must have a Targeted Case Management Provider Interactive Video Assurance Statement (DHS-8398) on their provider file to provide services via ITV.
SOURCE: MN Dept. of Human Services, Child Welfare Targeted Case Management (CW-TCM) Jan. 11, 2024. (Accessed Nov. 2024).
Dental
Consultations performed by providers who are not located in Minnesota and contiguous counties require authorization prior to the service being provided.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Dental Svcs. Jan. 16, 2024 (Accessed Nov. 2024).
FACILITY/TRANSMISSION FEE
Early Intensive Developmental and Behavioral Intervention (EIDBI) services
MHCP does not reimburse for connection charges or origination, set-up or site fees.
SOURCE: MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services. 8/6/24. (Accessed Nov. 2024).
Physician and Professional Services
MHCP does not pay an originating site facility fee. Services billed on an outpatient claim with the GQ modifier will pay zero.
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024, (Accessed Nov. 2024).
Mental Health Delivery
MHCP does not pay an originating site facility fee. Services billed on an outpatient claim with the GQ modifier will pay zero.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Telehealth Delivery of Mental Health Services, Revised Oct. 17, 2022 (Accessed Nov. 2024).
Prior to the delivery of nonemergency services, a provider-based clinic that charges a facility fee shall provide notice to any patient, including patients served by telehealth as defined in section 62A.673, subdivision 2, paragraph (h), stating that the clinic is part of a hospital and the patient may receive a separate charge or billing for the facility component, which may result in a higher out-of-pocket expense.
SOURCE: MN Statute Sec. 62J.824, (Accessed Nov. 2024).
