Minnesota

Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

At A Glance
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MEDICAID REIMBURSEMENT

  • Live Video: Yes
  • Store-and-Forward: Yes
  • Remote Patient Monitoring: Yes
  • Audio Only: Yes

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: Yes

PROFESSIONAL REQUIREMENTS

  • Licensure Compacts: ASLP-IC, CC, IMLC, OT, PA, PSY, SW
  • Consent Requirements: Yes

STATE RESOURCES

  1. Medicaid Program: Medical Assistance
  2. Administrator: Minnesota Dept. of Human Services
  3. Regional Telehealth Resource Center: Great Plains Telehealth Resource and Assistance Center
Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Last updated 06/24/2024

Definitions

“Telehealth” means the delivery of health care services or consultations through the use of real time two-way interactive audio and visual communications to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care. Telehealth includes the application of secure video conferencing, store-and-forward technology, and synchronous interactions between a patient located at an originating site and a health care provider located at a distant site. Until July 1, 2025, telehealth also includes audio-only communication between a health care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth does not include communication between health care providers that consists solely of a telephone conversation, email, or facsimile transmission. Telehealth does not include communication between a health care provider and a patient that consists solely of an email or facsimile transmission. Telehealth does not include telemonitoring services as defined in paragraph (i).

“Telemonitoring services” means the remote monitoring of clinical data related to the enrollee’s vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a health care provider for analysis. Telemonitoring is intended to collect an enrollee’s health-related data for the purpose of assisting a health care provider in assessing and monitoring the enrollee’s medical condition or status.

SOURCE: MN Statute Sec. 62A.673(h) (Accessed Jun. 2024).

Last updated 06/24/2024

Parity

SERVICE PARITY

A health carrier must not restrict or deny coverage of a health care service that is covered under a health plan solely:

  • because the health care service provided by the health care provider through telehealth is not provided through in-person contact; or
  • based on the communication technology or application used to deliver the health care service through telehealth, provided the technology or application complies with this section and is appropriate for the particular service.

SOURCE: MN Statute Sec. 62A.673. (Accessed Jun. 2024).


PAYMENT PARITY

A health carrier must reimburse the health care provider for services delivered through telehealth on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered by the health care provider through in-person contact.

A health carrier must not deny or limit reimbursement based solely on a health care provider delivering the service or consultation through telehealth instead of through in-person contact.

A health carrier must not deny or limit reimbursement based solely on the technology and equipment used by the health care provider to deliver the health care service or consultation through telehealth, provided the technology and equipment used by the provider meets the requirements of this section and is appropriate for the particular service.

Nothing in this subdivision prohibits a health carrier and health care provider from entering into a contract that includes a value-based reimbursement arrangement for the delivery of covered services that may include services delivered through telehealth, and such an arrangement shall not be considered a violation of this subdivision.

SOURCE: MN Statute Sec. 62A.673. (Accessed Jun. 2024).

Last updated 06/24/2024

Requirements

A health plan sold, issued, or renewed by a health carrier in Minnesota must (1) cover benefits delivered through telehealth in the same manner as any other benefits covered under the health plan, and (2) comply with this section.

Coverage for services delivered through telehealth must not be limited on the basis of geography, location, or distance for travel subject to the health care provider network available to the enrollee through the enrollee’s health plan.

A health carrier must not create a separate provider network to deliver services through telehealth that does not include network providers who provide in-person care to patients for the same service or require an enrollee to use a specific provider within the network to receive services through telehealth.

A health carrier may require a deductible, co-payment, or coinsurance payment for a health care service provided through telehealth, provided that the deductible, co-payment, or coinsurance payment is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable for the same service provided through in-person contact.

Nothing in this section

  • requires a health carrier to provide coverage for services that are not medically necessary or are not covered under the enrollee’s health plan; or prohibits a health carrier from:
    • establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service through telehealth for which the health carrier does not already reimburse other health care providers for delivering the service through telehealth;
    • establishing reasonable medical management techniques, provided the criteria or techniques are not unduly burdensome or unreasonable for the particular service; or
    • requiring documentation or billing practices designed to protect the health carrier or patient from fraudulent claims, provided the practices are not unduly burdensome or unreasonable for the particular service.

Nothing in this section requires the use of telehealth when a health care provider determines that the delivery of a health care service through telehealth is not appropriate or when an enrollee chooses not to receive a health care service through telehealth.

Prior authorization may be required for health care services delivered through telehealth only if prior authorization is required before the delivery of the same service through in-person contact.

A health carrier may require a utilization review for services delivered through telehealth, provided the utilization review is conducted in the same manner and uses the same clinical review criteria as a utilization review for the same services delivered through in-person contact.

A health carrier or health care provider shall not require an enrollee to pay a fee to download a specific communication technology or application.

Telehealth Equipment

A health carrier must not require a health care provider to use specific telecommunications technology and equipment as a condition of coverage under this section, provided the health care provider uses telecommunications technology and equipment that complies with current industry interoperable standards and complies with standards required under the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and regulations promulgated under that Act, unless authorized under this section.

Telemonitoring Services

A health carrier must provide coverage for telemonitoring services if:

  • the telemonitoring service is medically appropriate based on the enrollee’s medical condition or status;
  • the enrollee is cognitively and physically capable of operating the monitoring device or equipment, or the enrollee has a caregiver who is willing and able to assist with the monitoring device or equipment; and
  • the enrollee resides in a setting that is suitable for telemonitoring and not in a setting that has health care staff on site.

Exception

This section does not apply to coverage provided to state public health care program enrollees under chapter 256B or 256L.

SOURCE: MN Statute Sec. 62A.673. (Accessed Jun. 2024).

Network Adequacy

In determining network adequacy, the commissioner of health shall consider availability of services.  See statute for details.

The commissioner may establish sufficiency by referencing any reasonable criteria, which include but are not limited to: …

  • other health care service delivery system options, including telemedicine or telehealth, mobile clinics, centers of excellence, and other ways of delivering care

SOURCE: MN Revised Statute Sec. 62K.10, (accessed Jun. 2024).

Last updated 06/24/2024

Definitions

“Telehealth” means the delivery of health care services or consultations using real-time two-way interactive audio and visual communication or accessible telehealth video-based platforms to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care. Telehealth includes: the application of secure video conferencing consisting of a real-time, full-motion synchronized video; store-and-forward technology; and synchronous interactions, between a patient located at an originating site and a health care provider located at a distant site. Telehealth does not include communication between health care providers, or between a health care provider and a patient that consists solely of an audio-only communication, email, or facsimile transmission or as specified by law

SOURCE:  MN Statute 256B.0625, Subd. 3b, (e)(1), (Accessed Jun. 2024).

Telehealth is defined as the delivery of health care services or consultations through the use of real time, two-way interactive audio and visual communications. The purpose of telehealth is to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment education, and care management of a member’s health care while the member is at an originating site and the licensed health care provider is at a distant site.

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 Jun. 2024).

Telehealth includes:

  • Secure video conferencing
  • Store-and-forward technology
  • Audio-only communication between the health care provider and the patient (until July 1, 2025)

SOURCE: MN Dept. of Human Services, Provider Manual, Telehealth Services, As revised Jun. 2, 2023. (Accessed Jun. 2024).

“Telehealth” means the practice of medicine as defined in Minnesota Statutes, section 147.081, subdivision 3, when the health care practitioner is not in the physical presence of the patient.

SOURCE: MN Admin Rules 4770.4002 Subp. 23. (Accessed Jun. 2024).

Chemical Dependency Treatment

“Telehealth” means the delivery of a substance use disorder treatment service while the client is at an originating site and the health care provider is at a distant site via telehealth as defined in section 256B.0625, subdivision 3b, and as specified in section 254B.05, subdivision 5, paragraph (f).

SOURCE: MN Statute Sec. 245G.01 Subd. 26. (Accessed Jun. 2024).

Home Health Agency

“Telehomecare” means the use of telecommunications technology via live, two-way interactive audiovisual technology which may be augmented by store-and-forward technology.

SOURCE: MN Statute Sec. 256B.0653(l). (Accessed Jun. 2024).

Teledentistry Services

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.

SOURCE: MN Department of Human Services, Teledentistry Services, Revised Jan. 16, 2024. (Accessed Jun. 2024).

Telehealth Delivery of Mental Health Services

Telehealth is the delivery of health care services or consultations through the use of real time, two-way interactive audio and visual communications. Telehealth provides or supports health care delivery and facilitates the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care while the patient is at originating site and the licensed health care professional is at a distant site. Telehealth includes the application of secure video conferencing, store-and-forward technology, and synchronous interactions between a patient located at an originating site and a health care provider located at a distant site.

SOURCE: MN Dept. of Human Services, Provider Manual, Telemedicine Delivery of Mental Health Services, Revised Oct. 17, 2022, (Accessed Jun. 2024).

 

Last updated 06/24/2024

Email, Phone & Fax

Telehealth does not include communication between health care providers, or between a health care provider and a patient that consists solely of an audio-only communication, email, or facsimile transmission or as specified by law

SOURCE: MN Statute Sec. 256B.0625, Subsection 3(b)(e)(1). (Accessed Jun. 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.

SOURCE: MN Dept. of Human Svcs., Provider Manual, Child Welfare Case Management Services, As revised Jan. 11, 2024. (Accessed Jun. 2024).

Audio only (until July 1, 2025)

Audio only is the delivery of health care services or consultations through telephone communication while the patient is at one site and the qualified health care provider is at a distant site.

Audio-only communication will be covered if:

  • There is a scheduled appointment and the standard of care for that particular service can be met through the use of audio-only communication.
  • Substance use disorder (SUD) treatment services and mental health services delivered without a scheduled appointment when initiated by the member while in an emergency or crisis situation and a scheduled appointment was not possible due to the need of an immediate response.

Telehealth does not include:

  • Communication between health care provider and a patient that consists solely of an email or facsimile.
  • Electronic connections that are not conducted over a secure encrypted website as specified by the Health Insurance Portability and Accountability Act of 1996 Privacy and Security rules
  • Prescription renewal
  • Scheduling a test or appointment
  • Clarification of issues from a previous visit
  • Reporting test results
  • Nonclinical communication

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).

  • 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 Provider Manual, Jun. 2, 2023. (Accessed Jun. 2024).

Audio-only continues to be an allowable telehealth modality until July 1, 2025.

SOURCE: MN Dept. of Human Services, Coronavirus Manual, Mar. 13, 2024. (Accessed Jun. 2024).

New Telehealth Modifier and Use of Current Telehealth Modifiers

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.

SOURCE: MN Dept. of Human Svcs., Provider Manual, Telehealth Delivery of Mental Health Services, Revised Oct. 2022 (Accessed Jun. 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 Jun. 2024).

Smoking Cessation

Medical assistance covers telephone cessation counseling services provided through a quitline. Notwithstanding section 256B.0625, subdivision 3b, quitline services may be provided through audio-only communications. The commissioner of human services may utilize volume purchasing for quitline services consistent with section 256B.04, subdivision 14.

SOURCE: MN Statute Sec. 256B.0625, (Accessed Jun. 2023).

Program HH (HIV/AIDS) Services – MTMS Covered Services

In addition to the covered services included under MTMS in the MHCP Provider Manual, Program HH also covers services provided by telephone. Providers should follow the MHCP Telehealth Services policy.

SOURCE: MN Dept. of Human Services, Program HH (HIV/AIDS) Services, May 23, 2024 (Accessed Jun. 2024).

IEP Services

MHCP telehealth coverage will not pay the following:  …

  • Communication via telephone, email or fax

SOURCE: MN Dept. of Human Svcs., Provider Manual, IEP Services, As revised May 19, 2022 ; MN Dept. of Human Svcs. Provider Manual Rehabilitation Services, Jan. 25, 2022.  (Accessed Jun. 2024).

Telehealth Delivery of Substance Use Disorder Services

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.

SOURCE: MN Dept. of Human Svcs., Provider Manual, Substance Use Disorder Telehealth, May 23, 2023, (Accessed Jun. 2024).

Federally Qualified Health Center and Rural Health Clinic

Effective July 1, 2025, audio-only communication will end as part of a face-to-face encounter payment methodology.

SOURCE: MN Dept of Human Services, Federally Qualified Health Center and Rural Health Clinic, Mar. 18, 2024, (Accessed Jun. 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.

SOURCE:  MN Statute Sec. 256B.0911 & Senate File 4399 (2024 Session), (Accessed Jun. 2024).

Long Term Care Options Counseling at Critical Care Transitions

Counseling must be delivered by Senior LinkAge Line either by telephone or in-person.

See statute for requirements.

SOURCE:  MN Statute Sec. 256.975 & Senate File 4399 (2024 Session), (Accessed Jun. 2024).

Mental Health Services – Noncovered Services

SOURCE: MN Dept. of Human Svcs., Provider Manual, Mental Health Services, Apr. 17, 2024 (Accessed Jun. 2024)

Behavioral Health Home Services

To submit claims for delivery of BHH services, certified providers must:

  • Have personal contact with the person or the identified support at least once per month. Personal contact may include face-to-face, telephone contact or interactive video. An email, letter, voicemail or text alone does not meet the requirement for monthly personal contact.
  • At a minimum, offer a face-to-face visit with the member at least every six months. If the member declines the offer of a face-to-face visit, the visit may be completed by telephone contact or interactive video.

SOURCE:  MN Dept. of Human Svcs. Provider Manual Behavioral Health Home Services Nov. 1, 2023.  (Accessed June 2024).

Adult Mental Health Targeted Case Management (AMH-TCM) and Children’s Mental Health Targeted Case Management (CMH-TCM)

AMH-TCM case managers may meet with the member via face-to-face, ITV or telephone. Telephone contact may occur for up to two months before ITV or face-to-face contact must be made. It is best practice to see the person every month.

SOURCE: MN Dept. of Human Svcs, Provider Manual Adult Mental Health Targeted Case Management (AMH-TCM) and Children’s Mental Health Targeted Case Management (CMH-TCM) Nov. 13, 2023.  (Accessed Jun. 2024).

Vulnerable Adult/Developmental Disability Targeted Case Management (VA/DD-TCM)

Any provider who uses Social Services Information System (SSIS) uses the following SSIS workgroups, services, activities and contact methods for document and billing purposes:

  • Client contact; contact method either face-to-face, interactive video or by telephone
  • Collateral contact; contact method either face-to-face, interactive video or by telephone

SSIS contact methods:

  • Face-to-face.
  • Interactive video.
  • Phone.

SOURCE:  MN Dept. of Human Svcs, Provider Manual Vulnerable Adult/Developmental Disability Targeted Case Management (VA/DD-TCM) Oct. 3, 2023.  (Accessed Jun. 2024).

Long Term Care Options Counseling at Critical Care Transitions

Counseling must be delivered by Senior LinkAge Line either by telephone or in-person.

See statute for requirements.

SOURCE:  MN Statute Sec. 256.975 & Senate File 4399 (2024 Session), (Accessed Jun. 2024).

Last updated 06/24/2024

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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 2024).

Telehealth does not include:

  • Communication between health care provider and a patient that consists solely of an email or facsimile.
  • Electronic connections that are not conducted over a secure encrypted website as specified by the Health Insurance Portability and Accountability Act of 1996 Privacy and Security rules
  • Prescription renewal
  • Scheduling a test or appointment
  • Clarification of issues from a previous visit
  • Reporting test results
  • Nonclinical communication

SOURCE: MN Dept. of Human Services, Provider Manual, Telehealth Services, As revised Jun. 2, 2023. (Accessed Jun. 2024).

Non-covered services:

SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2023, (Accessed Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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, Jun. 2024, (Accessed Jun. 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 Jun. 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 Jun. 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 Jun. 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 June 2024 & MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services.  Mar. 16, 2022. (Accessed Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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. 1, 2023. (Accessed Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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, Mar. 18, 2024. (Accessed Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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.

A comprehensive multi-disciplinary evaluation provider, qualified supervising professional, (Level I or Level II) EIDBI provider may apply to provide EIDBI services via telehealth.

SOURCE: MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services.  Mar. 16, 2022.  (Accessed Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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 Jun. 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: …

  • Telemedicine

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 Jun. 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 Jun. 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 Jun. 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 Jun. 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. Mar. 16, 2022. (Accessed Jun. 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 Jun. 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 Jun. 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 Jun. 2024).

Last updated 06/24/2024

Miscellaneous

Early Intensive Developmental and Behavioral Intervention (EIDBI) services

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.

SOURCE: MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services.  Mar. 16, 2022.  (Accessed Jun. 2024).

Last updated 06/24/2024

Out of State Providers

Out-of-state coverage policy applies to services provided via telehealth.

See out-of-state providers section of manual.

SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024, MN Dept of Human Services, Provider Manual, Provider Basics: Out-of-State Providers.  Revised 5/19/21  &MN Dept. of Human Svcs, Provider Manual Rehabilitation Services Jan. 25, 2022.  (Accessed Jun. 2024).

1115 Substance Use Disorder System Reform Demonstration

A provider seeking to enroll in the 1115 SUD Reform Demonstration must be enrolled as an MHCP provider for Substance Use Disorder (SUD) Services. To enroll, providers must submit the forms listed under the 1115 SUD System Reform Demonstration heading on the Substance Use Disorder (SUD) Services Enrollment Criteria and Forms provider enrollment webpage. Providers must meet the requirements listed on these forms and submit the forms to DHS to be eligible to provide, bill and be paid by MHCP for SUD services within the 1115 SUD System Reform Demonstration.

Eligible providers may include the following:

  • Licensed residential SUD treatment programs
  • Licensed nonresidential (outpatient) SUD treatment programs
  • Tribes
  • Licensed withdrawal management programs
  • Approved out-of-state SUD providers

SOURCE: MN Dept of Health Svcs Provider Manual Substance Use Disorder (SUD) Services Jun. 17, 2024.  (Accessed Jun. 2024).

Last updated 06/24/2024

Overview

Minnesota Medicaid provides reimbursement for live video, store-and-forward and telemonitoring through their Medical Assistance (MA) program for certain providers when patients are located at specific originating sites.  Many of their individual programs have their own unique requirements for telehealth reimbursement.  MA is covering audio-only through an expansion of emergency waivers until July 1, 2025.

Last updated 06/24/2024

Remote Patient Monitoring

POLICY

Telemonitoring (Remote Physiological Monitoring Services)

Medical assistance covers telemonitoring services if:

  • The telemonitoring service is medically appropriate based on the recipient’s medical condition or status;
  • The recipient’s health care provider has identified that telemonitoring services would likely prevent the recipient’s admission or readmission to a hospital, emergency room, or nursing facility;
  • The recipient is cognitively and physically capable of operating the monitoring device or equipment, or the recipient has a caregiver who is willing and able to assist with the monitoring device or equipment; and
  • The recipient resides in a setting that is suitable for telemonitoring and not in a setting that has health care staff on site.

“Telemonitoring services” means the remote monitoring of data related to a recipient’s vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a provider for analysis. The assessment and monitoring of the health data transmitted by telemonitoring must be performed by one of the following licensed health care professionals: physician, podiatrist, registered nurse, advanced practice registered nurse, physician assistant, respiratory therapist, or licensed professional working under the supervision of a medical director.

SOURCE: MN Statute Sec. 256B.0625 Subd. 3(h). (Accessed Jun. 2024).

Telemonitoring services are the remote monitoring of data related to a member’s vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a provider for analysis. Telemonitoring is a tool that can assist the provider in managing a member’s complex health needs.

MHCP covers telemonitoring services for MHCP members in fee-for-service programs.

SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024. (Accessed Jun. 2024).

There is reimbursement for “tele-homecare” under Elderly Waiver (EW) and Alternative Care (AC) programs.

SOURCE: MN Dept. of Human Svcs., Provider Manual, Elderly Waiver (EW) and Alternative Care (AC) Program, As revised Sept.  6, 2023, (Accessed Jun. 2024).

A face-to-face visit can occur through telehealth.

Prior authorization for home care services is required for: …

  • All telehomecare skilled nurse visits

SOURCE: MN Dept. of Human Svcs., Provider Manual, Home Care Svcs., As revised Jan. 31, 2024, (Accessed Jun. 2024).


CONDITIONS

MHCP covers telemonitoring services for members in high-risk, medically complex patient populations. These members have medical conditions like congestive heart failure, chronic obstructive pulmonary disease (COPD) or diabetes.

MHCP covers telemonitoring services based on the following medical necessity criteria:

  • The telemonitoring service is medically appropriate based on the member’s medical condition or status.
  • The member is cognitively and physically capable of operating the monitoring device or equipment, or the member has a caregiver who is willing and able to assist with the monitoring device or equipment.
  • The member resides in a setting that is suitable for telemonitoring and not in a setting that has health care staff on site.
  • The prescribing provider has identified and documented how telemonitoring services would likely prevent the member’s admission or readmission to a hospital, emergency room or nursing facility.
  • The results of the telemonitoring services are directly used to impact the plan of care.

Any service that does not meet medical necessity criteria will not be covered.

Bill on 837P claim format. Refer to the MN–ITS 837P Professional User Guides.

Submit claims for telemonitoring services using the CPT or HCPC code that describes the services rendered. Prior-authorization is not needed.

Provider must bill for at least 16 days of data collection within a 30 day period.

The data must be collected and transmitted rather than self-reported to the provider. The device must be defined by the FDA as a medical device.

Only MDs and practitioners may bill for remote patient monitoring (RPM) services.

Independent diagnostic testing facilities are not able to bill for RPM services.

SOURCE:  Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024. (Accessed Jun. 2024).

Medical assistance covers telemonitoring services if:

  • the telemonitoring service is medically appropriate based on the recipient’s medical condition or status;
  • the recipient’s health care provider has identified that telemonitoring services would likely prevent the recipient’s admission or readmission to a hospital, emergency room, or nursing facility;
  • the recipient is cognitively and physically capable of operating the monitoring device or equipment, or the recipient has a caregiver who is willing and able to assist with the monitoring device or equipment; and
  • the recipient resides in a setting that is suitable for telemonitoring and not in a setting that has health care staff on site.

SOURCE: MN Statute Sec. 256B.0625 Subd. 3(h), (Accessed Jun. 2024).

Seizure Detection Devices

The following codes and seizure detection devices are covered by MHCP:

  • A9279: Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components, and electronics, not otherwise classified. MHCP covers one device every five years. Bill using U2 modifier.
  • 99454: Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days. Refer to Telemonitoring Policy for more information. Bill using U2 modifier. MHCP only covers the standard plan subscription.

SOURCE: MN Dept of Human Services, Seizure Detection Devices, Apr. 17, 2024, (Accessed Jun. 2024).


PROVIDER LIMITATIONS

The assessment and monitoring of the health data transmitted by telemonitoring must be performed by the following licensed health care professionals:

  • Advanced practice registered nurse
  • Physician
  • Physician assistant
  • Podiatrist
  • Registered nurse
  • Respiratory therapist
  • a licensed professional working under the supervision of a medical director (for example, an LPN)

Only MDs and practitioners may bill for remote patient monitoring (RPM) services.

SOURCE:  MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024. (Accessed Jun. 2024).

For purposes of this subdivision, “telemonitoring services” means the remote monitoring of data related to a recipient’s vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a provider for analysis. The assessment and monitoring of the health data transmitted by telemonitoring must be performed by one of the following licensed health care professionals: physician, podiatrist, registered nurse, advanced practice registered nurse, physician assistant, respiratory therapist, or licensed professional working under the supervision of a medical director.

SOURCE: MN Statute Sec. 256B.0625 Subd. 3(h), (Accessed Jun. 2024).


OTHER RESTRICTIONS

Bill on 837P claim format. Refer to the MN–ITS 837P Professional User Guides.

Submit claims for telemonitoring services using the CPT or HCPC code that describes the services rendered. Prior authorization is not needed.

You must bill for at least 16 days of data collection within a 30-day period.

The data must be collected and transmitted rather than self-reported to the provider. The device must be defined by the FDA as a medical device.

Only MDs and practitioners may bill for remote patient monitoring (RPM) services.

Independent diagnostic testing facilities are not able to bill for RPM services.

SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024. (Accessed Jun. 2024).

Telehomecare visits. Coverage of telehomecare is limited to two visits per day and all of the visits must be prior authorized.

SOURCE: MN Dept. of Human Services, Skilled Nursing Visit Services, Oct. 5, 2018, (Accessed Jun. 2024).

Last updated 06/24/2024

Store and Forward

POLICY

“Telehealth” means the delivery of health care services or consultations using real-time two-way interactive audio and visual communication or accessible telehealth video-based platforms to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care. Telehealth includes: the application of secure video conferencing consisting of a real-time, full-motion synchronized video; store-and-forward technology; and synchronous interactions, between a patient located at an originating site and a health care provider located at a distant site. Telehealth does not include communication between health care providers, or between a health care provider and a patient that consists solely of an audio-only communication, email, or facsimile transmission or as specified by law

SOURCE: MN Statute Sec. 256B.0625 Subd. 3b(e)(1).   (Accessed Jun. 2024).

Telehealth includes:

  • Secure video conferencing
  • Store-and-forward technology
  • Audio-only communication between the health care provider and the patient (until July 1, 2025)

Store-and-forward is the asynchronous electronic transfer or transmission of a patient’s medical information or data from the originating site to a distant site for purposes of diagnostic and therapeutic assistance in the care of the patient. Medical information may include, but is not limited to, video clips, still images, X-rays, MRIs, EKGs, laboratory results, audio clips and text. The physician at the distant site reviews the case without the patient being present. Store-and-forward substitutes for an interactive encounter with the patient present; the patient is not present in real-time.

SOURCE:  MN Dept. of Human Services, Provider Manual, Telehealth Services, As revised Jun. 2, 2023. (Accessed Jun. 2024).

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 Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Apr. 4, 2024, (Accessed Jun. 2024).


ELIGIBLE SERVICES/SPECIALTIES

See Live Video Eligible Services section for examples of eligible telemedicine services as well as noncovered services.

In addition to other requirements, refer to the following general telehealth information:

  • Out-of-state coverage policy applies to services provided via telehealth
  • Payment will be made for only one reading or interpretation of diagnostic tests such as X-rays lab tests and diagnostic assessments

SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), Apr. 4, 2024, (Accessed Jun. 2024).

Rehabilitation Services

Telehealth coverage applies to MHCP members in fee-for-service programs. Prepaid health plans may choose whether to pay for services delivered in this manner.

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.

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.

Providers must self-attest that they meet all of the conditions of MHCP telehealth policy by completing the “Provider Assurance Statement for Telehealth”.

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.

MHCP allows payment for the following services: …

  • “Store and Forward”: Transmission of medical information in a way that it is stored to be reviewed later by a physician or practitioner at the distant site (known as asynchronous transmission). Medical information may include, but is not limited to, video clips, still images, x-rays, MRIs, EKGs, laboratory results, audio clips and text. The physician at the distant site reviews the case without the patient being present. “Store and forward” services substitute for an interactive encounter with the patient present; the patient is not present in real-time.

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

Eligible providers:

  • 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.

SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Jan. 25, 2022 (Accessed Jun. 2024).

Store-and-Forward Telemedicine for IEP Services

Store-and-forward telehealth is asynchronous, non-real-time communications. Service providers and members transfer data from one site to another via camera or similar device that records (stores) an image and forwards it by telecommunications to another site for consultation. It can be used to support health care delivery, including sending and receiving health-related instructions, activities, or tasks that are identified in the child’s Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP). Real-time, two-way interactive video with the school professional and child or parent must accompany the store-and-forward telehealth components.

Use store-and-forward telehealth when a child is distance learning at home. When a child is attending school in person, the school must provide IEP services either in person, or via two-way, interactive video conference.

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

SOURCE: MN Dept. of Human Svcs., Provider Manual, IEP Services, As revised May 19, 2022 (Accessed Jun. 2024).


GEOGRAPHIC LIMITS

Dental

Affiliate practice or originator within Minnesota Board of Dentistry defined scope of practice must be present at originating site.

Eligible Providers

  • Dentist
  • Advanced dental therapists
  • Dental therapists
  • Dental hygienists
  • Licensed dental assistants
  • Other licensed health care professionals

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 Jun. 2024).

Rehabilitation Services

The originating site is the location of an eligible MHCP member at the time the service is being furnished via a telecommunication system. Authorized originating sites are any of the following:

  • 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 telemedicine services provided in a private home)
  • School

SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Jan. 25, 2022 (Accessed Jun. 2024).


TRANSMISSION FEE

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, Physician and Professional Services (Telehealth), Jan. 4, 2024. (Accessed Jun. 2024).

 

Last updated 06/24/2024

Cross State Licensing

A physician not licensed to practice medicine in this state may provide medical services to a patient located in this state through interstate telehealth if the following conditions are met:

  • the physician is licensed without restriction to practice medicine in the state from which the physician provides telehealth services;
  • the physician has not had a license to practice medicine revoked or restricted in any state or jurisdiction;
  • the physician does not open an office in this state, does not meet with patients in this state, and does not receive calls in this state from patients; and
  • the physician annually registers with the board, on a form provided by the board.

See statute for registration requirements.

A physician who is not licensed to practice medicine in this state, but who holds a valid license to practice medicine in another state or jurisdiction, and who provides interstate telehealth services to a patient located in this state is not subject to the registration requirement of subdivision 1, paragraph (a), clause (4), if:

  • the services are provided in response to an emergency medical condition. For the purposes of this section, an emergency medical condition means a condition, including emergency labor and delivery, that manifests itself by acute symptoms of sufficient severity, including severe pain, that the absence of immediate medical attention could reasonably be expected to result in placing the patient’s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any body organ or part;
  • the services are provided on an irregular or infrequent basis. For the purposes of this section, a person provides services on an irregular or infrequent basis if the person provides the services less than once a month or provides the services to fewer than ten patients annually; or
  • the physician provides interstate telehealth services in this state in consultation with a physician licensed in this state and the Minnesota physician retains ultimate authority over the diagnosis and care of the patient.

The board shall obtain confirmation of licensure from all states and jurisdictions in which a physician registered under subdivision 1 has ever been licensed to verify statements made by the physician and to be notified if any future adverse action is taken against the physician’s license in another state or jurisdiction. This requirement does not replace the reporting obligation under section 147.111.

A physician who provides interstate telehealth services to a patient located in this state must comply with sections 144.291 to 144.298 with respect to the provision of those services.

SOURCE: MN Statute Sec. 147.032.  (Accessed Jun. 2024).

Last updated 06/24/2024

Definitions

“Telehealth” has the meaning given in section 62A.673, subdivision 2, paragraph (h):

“Telehealth” means the delivery of health care services or consultations through the use of real time two-way interactive audio and visual communications to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care. Telehealth includes the application of secure video conferencing, store-and-forward technology, and synchronous interactions between a patient located at an originating site and a health care provider located at a distant site. Until July 1, 2025, telehealth also includes audio-only communication between a health care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth does not include communication between health care providers that consists solely of a telephone conversation, email, or facsimile transmission. Telehealth does not include communication between a health care provider and a patient that consists solely of an email or facsimile transmission. Telehealth does not include telemonitoring services as defined in paragraph (i).

SOURCE: MN Statute Sec 147.033. (Accessed Jun. 2024).

Chemical Dependency Licensed Treatment Facilities

“Telehealth” means the delivery of a substance use disorder treatment service while the client is at an originating site and the health care provider is at a distant site via telehealth as defined in section 256B.0625, subdivision 3b, and as specified in section 254B.05, subdivision 5, paragraph (f).

SOURCE: MN Statute Section 245G.01, Subd. 26.  (Accessed Jun. 2024).

Medical Cannabis

“Telehealth” means the practice of medicine as defined in Minnesota Statutes, section 147.081, subdivision 3, when the health care practitioner is not in the physical presence of the patient.

SOURCE: MN Admin Rules 4770.4002 Subp 23.  (Accessed Jun. 2024). 

Integrated Treatment

For integrated treatment, “telehealth” has the meaning given to the phrase “mental health telehealth in Minnesota Statutes, section 256B.0625, subdivision 46, when telehealth is used to provide integrated treatment.

SOURCE: MN Admin Rules 9533.0020 Subp 38. (Accessed Jun. 2024).

Last updated 06/24/2024

Licensure Compacts

Member of Audiology and Speech Language Pathology Compact

SOURCE: Audiology and Speech Language Pathology Compact, Compact Map, (Accessed Jun. 2024).

Member of Counseling Compact

SOURCE: House File 5247 (2024 Legislation), & Counseling Compact, Compact Map, (Accessed Jun. 2024).

Member of the Interstate Medical Licensure Compact.

SOURCE: Interstate Medical Licensure Compact. (Accessed Jun. 2024).

Member of Occupational Therapy Licensure Compact

SOURCE: Occupational Therapy Licensure Compact, Compact Map, (Accessed Jun. 2024).

Member of Physician Assistant Compact

SOURCE: Physician Assistant Compact, Compact Map, (Accessed Jun. 2024).

Member of the Psychology Interjurisdictional Compact (PSYPACT).

SOURCE: PSYPACT, Compact Map, (Accessed Jun. 2024).

Member of Social Worker Compact

SOURCE: Social Worker Compact, Compact Map, (Accessed Jun. 2024).

*See Compact websites for implementation and license issuing status and other related requirements.

Last updated 06/24/2024

Miscellaneous

Chemical Dependency Licensed Treatment Facilities

“Face-to-face” means two-way, real-time, interactive and visual communication between a client and a treatment service provider and includes services delivered in person or via telehealth.

SOURCE: MN Statutes  254G.01. (Accessed Jun. 2024).

$1,200,000 in fiscal year 2024 is from the general fund for studies of telehealth expansion and payment parity. This is a onetime appropriation and is available until June 30, 2025.

SOURCE: MN Senate File 2995 (2023 Session), (Accessed Jun. 2024).

Beginning October 1, 2024, to the extent space is available, a school district or charter school must provide an enrolled secondary school student with access during regular school hours, and to the extent staff is available, before or after the school day on days when students receive instruction at school, to space at the school site that a student may use to receive mental health care through telehealth from a student’s licensed mental health provider. A secondary school must develop a plan with procedures to receive requests for access to the space.

The space must provide a student privacy to receive mental health care.

A student may use a school-issued device to receive mental health care through telehealth if such use is consistent with the district or school policy governing acceptable use of the school-issued device.

A school may require a student requesting access to space under this section to submit to the school a signed and dated consent from the student’s parent or guardian, or from the student if the student is age 16 or older, authorizing the student’s licensed mental health provider to release information from the student’s health record that is requested by the school to confirm the student is currently receiving mental health care from the provider. Such a consent is valid for the school year in which it is submitted.

This section is effective for the 2024-2025 school year and later.

SOURCE: MN Sec. 121A.216 & Senate File 3567 (2024 Session), (Accessed Jun. 2024).

Last updated 06/24/2024

Online Prescribing

“Telehealth” has the meaning given in section 62A.673, subdivision 2, paragraph (h).

A physician-patient relationship may be established through telehealth.

A physician providing health care services by telehealth in this state shall be held to the same standards of practice and conduct as provided in this chapter for in-person health care services.

SOURCE: MN Statute 147.033. (Accessed Jun. 2024).

A prescription drug order for the following drugs is not valid, unless it can be established that the prescription drug order was based on a documented patient evaluation, including an examination, adequate to establish a diagnosis and identify underlying conditions and contraindications to treatment:

  • Controlled substance drugs listed in section 152.02, subdivisions 3 to 5;
  • Drugs defined by the Board of Pharmacy as controlled substances under section 152.02, subdivisions 7, 8, and 12;
  • Muscle relaxants;
  • Centrally acting analgesics with opioid activity;
  • Drugs containing butalbital; or
  • Phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.

The requirement for an examination shall be met if:

An in-person examination has been completed in any of the following circumstances:

  • The prescribing practitioner examines the patient at the time the prescription or drug order is issued;
  • The prescribing practitioner has performed a prior examination of the patient;
  • Another prescribing practitioner practicing within the same group or clinic as the prescribing practitioner has examined the patient;
  • A consulting practitioner to whom the prescribing practitioner has referred the patient has examined the patient; or
  • The referring practitioner has performed an examination in the case of a consultant practitioner issuing a prescription or drug order when providing services by means of telehealth; or

The prescription order is for a drug listed in paragraph (d), clause (6), or for substance use disorder treatment with medications for opioid use disorder, and the prescribing practitioner has completed an examination of the patient via telehealth as defined in section 62A.673, subdivision 2, paragraph (h).

Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a drug through the use of a guideline or protocol pursuant to paragraph (a).

SOURCE: MN Statute Sec. 151.37 Subd. 2(d) & (e).(Accessed Jun. 2024).

Optometry

For the purposes of a provider prescribing ophthalmic goods to a patient, the provider must establish a provider-patient relationship through an examination pursuant to paragraph (c).

An examination meets the requirements of paragraph (b) if it takes place:

  1. In person;
  2. through face-to-face interactive, two-way, real-time communication; or
  3. through store-and-forward technologies when all of the following conditions are met:
    1. The provider obtains an updated medical history and makes a diagnosis at the time of prescribing;
    2. the provider conforms to the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out through the use of peripheral devices appropriate to the patient’s condition;
    3. the ophthalmic prescription is not determined solely by use of an online questionnaire;
    4. the provider is licensed and authorized to issue an ophthalmic prescription in MN; and
    5. upon request, the provider provides patient records in a timely manner in accordance with state and federal requirements.

This subdivision does not apply to the sale of over-the-counter eyeglasses, also known as readers, that are not designed to address the visual needs of the individual wearer.

SOURCE:  MN Statute Sec. 145.713, Subd. 4, (Accessed Jun. 2024).

Medical Cannabis

Before issuing a written certification of qualifying condition, a health care practitioner must: …

  • assess the patient’s medical history and current medical condition, which includes:
    • an in-person physical examination of the patient appropriate to confirm the diagnosis of a qualifying medical condition. This examination must not be performed by remote means, including telehealth or via the Internet; and
    • developing a treatment plan for the patient

SOURCE: MN Administrative Rule. 4770.4014, Subpart 2(B)(1). (Accessed Jun. 2024).

Controlled Substances – Medical Cannabis

A health care practitioner may utilize telehealth, as defined in section 62A.673, subdivision 2, for certifications and recertifications.

SOURCE: MN Statute Sec. 152.28, (Accessed Jun. 2024).

Last updated 06/24/2024

Professional Boards Standards

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