Last updated 09/11/2021
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 was delivered through in-person contact. Services or consultations delivered through telehealth are paid at the full allowable rate.
SOURCE: MN Statute Sec. 256B.0625, Subdivision 3b(a) As amended by HF 33 (2021 Session). (Accessed Sept. 2021).
Minnesota’s Medical Assistance program reimburses live video for fee-for-service programs.
To be eligible for reimbursement, providers must self-attest that they meet the conditions of the MHCP telemedicine policy by completing the Provider Assurance Statement for Telemedicine form.
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Sept. 2, 2021. (Accessed Sept. 2021).
ELIGIBLE SERVICES/SPECIALTIES
Examples of eligible services:
- Consultations
- Telehealth consults: emergency department or initial inpatient care
- Subsequent hospital care services with the limitation of one telemedicine visit every 30 days per eligible provider
- Subsequent nursing facility care services with the limitation of one telemedicine 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
- Alcohol and substance abuse (other than tobacco) structured assessment and intervention services
Two-way interactive video consultation in an emergency room (ER) may be billed when no physician is in the ER and the nursing staff is caring for the patient at the originating site. The ER physician bills the ER CPT codes with place of service 02.
Telemedicine consults are limited to three per calendar week per patient (HF 33 (2021 Session) removed this limit from statute but as of Sept. 2021, the Provider Manual does not yet reflect the change). Payment is not available for sending materials to a recipient, other provider or facility.
Non-covered services:
- Electronic connections that are not conducted over a secure encrypted website as specified by the Health Insurance Portability & Accountability Act of 1996 Privacy & Security rules (e.g., Skype)
- Prescription renewals
- Scheduling a test or appointment
- Clarification of issues from a previous visit
- Reporting test results
- Non-clinical communication
- Communication via telephone, email or facsimile
- Day treatment
- Partial hospitalization programs
- Residential treatment services
- Case management face-to-face contact
In addition, Minnesota also has the following general requirements for its telemedicine policy:
- Out-of-state coverage policy applies to services provided via telemedicine
- Payment will be made for only one reading or interpretation of diagnostic tests such as x-rays, lab tests and diagnostic assessments
- Payment is not available to providers for sending materials to members, other providers or facilities
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Sept 2, 2021. (Accessed Sept. 2021).
Mental Health Services
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 As amended by HF 33 (2021 Session).(Accessed Sept. 2021).
MHCP covers medically necessary mental health services delivered by a health care provider via telemedicine.
SOURCE: MN Dept. of Human Services, Provider Manual, Telemedicine Delivery of Mental Health Services, Revised 10/19/2018, (Accessed Sept. 2021).
Assertive Community Treatment and Intensive Residential Treatment Services
Physician services, whether billed separately or included in the rate, may be delivered by telemedicine when it is used to provide intensive residential treatment services.
SOURCE: MN Statute Sec 256B.0622, subdivision 8(e) (Accessed Sept. 2021).
Individualized Education Program (IEP)
Telemedicine coverage applies to a child or youth who is MA eligible, has an IEP and the service provided is identified in the IEP. Whether the originating site is a home or school must be documented in the child’s health record. Limited to three visits per week per child or youth.
To be eligible for reimbursement, the school or school district must self-attest that the telemedicine services provided by the professional provider either employed by or contracted by the school meet all of the conditions of the MHCP telemedicine policy by completing the Provider Assurance Statement for Telemedicine (DHS-6806) (PDF).
Non-Covered Services:
- Evaluation or assessments that are less effective than if provided in-person, face-to-face
- Supervision evaluations or visits
- Personal care assistants
- Nursing services
- Transportation services
- Electronic connections that are conducted over a website that is not secure and encrypted as specified by the Health Insurance Portability & Accountability Act of 1996 Privacy & Security rules (for example, Skype)
- Prescription renewals
- Scheduling a test or appointment
- Clarification of issues from a previous visit
- Reporting test results
- Non-clinical communication
- Communication via telephone, email or fax
Use 02 place of service code. See IEP manual for specific documentation and billing requirements.
SOURCE: MN Dept. of Human Svcs., Provider Manual, IEP Services, Revised 7/22/2021 (Accessed Sept. 2021).
Mental Health Services
Providers authorized to provide mental health services may conduct the same services via telemedicine, except:
- Children’s day treatment
- Partial hospitalization programs
- Mental health residential treatment services
- Case management services delivered to children
Providers should bill with the place of service code 02.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Telemedicine Delivery of Mental Health Services, Revised 10/19/18 Accessed Sept. 2021).
Alcohol and Drug Abuse Services
Individual, non-residential treatment is the only substance use disorder service reimbursed when delivered via telemedicine.
Non-covered Services:
- Electronic connections that are not conducted over a secure encrypted web site as specified by the Health Insurance Portability & Accountability Act of 1996 (e.g., Skype)
- Prescription renewals
- Scheduling a test or appointment
- Reporting test results
- Non-clinical communication
- Communication via telephone, email or facsimile
Limited to three telemedicine services per week per recipient. Payment is not available to providers for sending materials. See manual for documentation requirements. Use the GT modifier.
SOURCE: Substance Use Disorder Telemedicine, Oct. 19, 2017 (Accessed Sept. 2021).
Dental
MHCP allows payment for teledentistry services. Reimbursement for teledentistry is the same as face-to-face encounters. See list of codes, documentation and billing requirements in provider manual. A provider must self-attest to meet all the conditions of the MHCP telemedicine policy by completing the Provider Assurance Statement for telemedicine.
Covered Services (See manual for exact CDT codes):
- 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 radiographic imaging
- Bitewing radiographic imaging
- Intraoral—occlusal radiographic image
- Panoramic radiographic imaging
- Medical dental consultation
SOURCE (Dental): MN Dept. of Human Svcs., Provider Manual, Dental Svcs. Dec. 24, 2020 (Accessed Sept. 2021).
Early Intensive Developmental and Behavioral Intervention (EIDBI) EIDBI services
Telehealth is an option for Early Intensive Developmental and Behavioral Intervention (EIDBI) EIDBI services. Use 02 place of service code.
Eligible services include:
- Comprehensive multi-disciplinary evaluation
- Coordinated care conference
- Family/caregiver training and counseling
- Individual treatment plan (ITP) development and progress monitoring
- Observation and direction
EIDBI Benefits grid also lists adaptive behavioral treatment by protocol and group adaptive behavior treatment by protocol. See grid for more information.
SOURCE: MN Dept. of Human Svcs., EIDBI Services Benefits billing grid, July 2021 (Accessed Sept. 2021) & MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telemedicine Services. July 21, 2021. (Accessed Sept. 2021).
Medical assistance covers medically necessary EIDBI services and consultations delivered by a licensed health care provider via telehealth, in the same manner as if the service or consultation was delivered in person.
SOURCE: MN Statute Sec. 256B.0949, Subdivision. 13. As Amended by HF 33 (2021 Session). (Accessed Sept. 2021).
Rehabilitation Services
MHCP allows payment for some rehabilitation services through telemedicine. Physical and occupational therapists, physical and occupational therapists assistants, speech-language pathologists and audiologists may use telemedicine to deliver certain covered rehabilitation therapy services that they can appropriately deliver via telemedicine. 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. Must use GT or GQ modifiers. Providers must self-attest that they meet all of the conditions of MHCP telemedicine policy by completing the “Provider Assurance Statement for Telemedicine”. When submitting claims for telemedicine services, use place-of-service code 02 to certify that the services meets the telemedicine requirements. The GQ modifier is required when billing for services via asynchronous telecommunication systems.
Limited to three sessions per week per member. Payment not available for sending materials to a recipient, other providers or other facilities. Payment is made only for one reading or interpretation of diagnostic tests such as x-rays, lab tests, and diagnostic assessments.
Noncovered services:
- 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
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Feb. 10, 2021 (Accessed Sept. 2021).
Medication Therapy Management Services (MTMS)
Under certain circumstances MTMS can be delivered via interactive video. See section on “eligible sites” for more information. To be eligible providers must submit a provider assurance statement, use equipment compliant with HIPAA (see manual for details) and use the GT modifier and 02 POS code.
Noncovered services:
- Encounters by telephone or by email
- Encounters in skilled nursing facilities
SOURCE: MN Dept. of Human Svcs., Provider Manual, Medication Therapy Management Svcs. Mar. 8, 2018 (Accessed Sept. 2021).
ELIGIBLE PROVIDERS
Providers must use the place of service code 02.
Eligible providers:
- 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 requirements and service limitations
- Pharmacist
- Certified genetic counselor
- Podiatrist
- Speech therapist
- Physical therapist
- Occupational therapist
- Audiologist
- Public health nursing organizations
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Sept. 2, 2021. (Accessed Sept. 2021).
Medical assistance covers medically necessary services and consultations delivered by a licensed health care provider via telehealth, which includes 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 256B.0615, subdivision 5, a mental health certified family peer specialist under section 256B.0616, subdivision 5, a mental health rehabilitation worker under section 256B.0623, subdivision 5, paragraph (a), clause (4), and paragraph (b), a mental health behavioral aide under section 256B.0943, subdivision 7, paragraph (b), clause (3), a treatment coordinator under section 245G.11, subdivision 7, an alcohol and drug counselor under section 245G.11, subdivision 5, a recovery peer under section 245G.11, subdivision 8.
Telehealth visits 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. As Amended by HF 33 (2021 Session). (Accessed Sept. 2021).
Individualized Education Program (IEP)
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 July 22, 2021. (Accessed Sept. 2021).
Early Intensive Developmental and Behavioral Intervention (EIDBI) 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 Telemedicine Services. July 21, 2021. (Accessed Sept. 2021).
Mental Health Services
All providers eligible to deliver mental health services may deliver the same eservices via telemedicine. See manual for specific requirements a provider must follow when delivering services via telemedicine. The following services may not be conducted via telemedicine:
- Children’s day treatment
- Partial hospitalization programs
- Mental health residential treatment services
- Case Management services delivered to children
SOURCE: MN Dept. of Human Svcs., Provider Manual, Telemedicine Delivery of Mental Health Services, Revised 10/19/18 (Accessed Sept. 2021).
Alcohol and Drug Abuse Services
All providers eligible to deliver the same services they are authorized to provide via telemedicine as long as they self-attest to meeting all of the conditions of the MHCP telemedicine policy by completing the Provider Assurance Statement for Telemedicine.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Substance Use Disorder Telemedicine, Oct. 19, 2017 (Accessed Sept. 2021).
Rehabilitation Services
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 telemedicine must follow the same supervision policy as indicated in “Rehabilitation Service Practitioners”. No distant site limitations beyond provider types. Providers must self-attest that they meet all of the conditions of MHCP telemedicine policy by completing the “Provider Assurance Statement for Telemedicine”. See manual for documentation requirements. When submitting claims for telemedicine services, use place-of-service code 02 to certify that the services meets the telemedicine requirements. The GQ modifier is required when billing for services via asynchronous telecommunication systems.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Feb. 10, 2021. (Accessed Sept. 2021).
ELIGIBLE SITES
Authorized originating sites include:
- 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, shelter or group housing
- 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
- Correctional facility-based office
- Mobile Stroke Unit
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services, As revised Sept. 2, 2021. (Accessed Sept. 2021).
Individualized Education Program (IEP)
Eligible originating sites, the location of the child or youth at the time the service is provided. Document in the child’s health record:
SOURCE: MN Dept. of Human Svcs., Provider Manual, Individualized Education Program, July 22, 2021 (Accessed Sept. 2021).
Medication Therapy Management Services (MTMS)
Qualified members who must travel more than twenty miles for enrolled MHCP MTMS provider may have the services delivered via interactive video to an ambulatory care site in which there is no enrolled MTMS provider in the local trade area. Services must meet the following criteria:
- Both the patient site and the pharmacist site must be located in a pharmacy, clinic, hospital or other ambulatory care site;
- The origination site must meet the MTMS privacy and space requirements except that the space would need to seat only two people comfortably;
- Qualified members may have the service delivered via interactive video to their residence if the service is performed during a covered home care visit by an MHCP enrolled provider;
- The pharmacist provider’s site must be located in a pharmacy, clinic, hospital or other ambulatory care site.
See manual for privacy, equipment and reimbursement requirements.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Medication Therapy Management Svcs. Mar. 8, 2018 (Accessed Sept. 2021).
Alcohol and Drug Abuse Services
Eligible originating sites:
- Substance abuse disorder treatment facility (residential or outpatient)
- Office of physician or practitioner
- Hospital (inpatient or outpatient)
- Withdrawal management facility
- Drug court office
- Correctional facility-based office (including jails)
- School
- Community mental health center (CCBHC)
- Residential facility 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)
SOURCE: MN Dept. of Human Svcs., Provider Manual, Substance Use Disorder Telemedicine, Oct. 19, 2017 (Accessed Sept. 2021).
Dental
Affiliate practice or originator within Minnesota Board of Dentistry defined scope of practice must be present at originating site:
- 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. December 24, 2020 (Accessed Sept. 2021).
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 telemedicine services provided in a private home)
- School
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Feb. 10, 2021. (Accessed Sept. 2021).
Tribal Facilities
Outpatient telemedicine services are reimbursable at the IHS outpatient reimbursement rate when provided through a tribal facility. 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 Sept. 2021).
GEOGRAPHIC LIMITS
Medication Therapy Management Services (MTMS)
Qualified members who must travel more than twenty miles for enrolled MHCP MTMS provider may have the services delivered via interactive video to an ambulatory care site in which there is no enrolled MTMS provider in the local trade area.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Medication Therapy Management Svcs. Mar. 8, 2018 (Accessed Sept. 2021).
FACILITY/TRANSMISSION FEE
Early Intensive Developmental and Behavioral Intervention (EIDBI) 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 Telemedicine Services. July 21, 2021. (Accessed Sept. 2021).
Last updated 09/11/2021
Miscellaneous
Clinical Supervision of Outpatient Mental Health Services
Clinical supervision must be conducted by a qualified supervisor using individual or group (or both) supervision. Individual or group face-to-face supervision may be conducted via electronic communications that utilize interactive telecommunications equipment that includes at a minimum audio and video equipment for two-way, real-time, interactive communication between the supervisor and supervisee, and meet the equipment and connection standards of telemedicine.
SOURCE: MN Dept. of Human Services, Provider Manual, Clinical Supervision of Outpatient Mental Health Services, 8/4/2016, (Accessed Sept. 2021).
Early Intensive Developmental and Behavioral Intervention (EIDBI) services
Services must be:
- Compliant with HIPAA and security requirements and regulation
- Medically appropriate to the condition and needs of the person and/or family.
SOURCE: MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telemedicine Services. July 21, 2021. (Accessed Sept. 2021).
Commissioner of Human Services: Extension of COVID-19 Human Services Program Modifications
When the peacetime emergency declared by the governor in response to the COVID-19 outbreak expires, is terminated, or is rescinded by the proper authority, the following modifications issued by the commissioner of human services pursuant to Executive Orders 20-11 and 20-12, and including any amendments to the modification issued before the peacetime emergency expires, shall remain in effect until July 1, 2023:
- CV16: expanding access to telemedicine services for Children’s Health Insurance Program, Medical Assistance, and MinnesotaCare enrollees; and
- CV21: allowing telemedicine alternative for school-linked mental health services and intermediate school district mental health services.
Study of Telehealth Expansion and Payment Parity
The commissioner of health, in consultation with the commissioners of human services and commerce, shall study the impact of telehealth expansion and payment parity under this article on the coverage and provision of health care services under public health care programs.
The study must review and make a number of recommendations relating to specified issues such as payment parity and audio-only policy impacts. A preliminary report is due by January 15, 2023 and should include whether audio-only communication should be allowed as a telehealth option beyond June 30, 2023. The commissioners shall present a final report to the chairs and ranking minority members of these specified legislative committees by January 15, 2024.
SOURCE: HF 33, Sec. 26 (2021 Session). (Accessed Sept. 2021).
Last updated 09/11/2021
Remote Patient Monitoring
POLICY
Telemonitoring (Remote Physiological Monitoring Services)
MHCP covers telemonitoring services for MHCP members in fee-for-service programs.
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.
SOURCE: MN Statute Sec. 256B.0625 Subd. 3(h) As Amended by HF 33 (2021 Session). (Accessed Sept. 2021). MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Sept. 2, 2021. (Accessed Sept. 2021).
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 November 6, 2020, (Accessed Sept. 2021).
Prior authorization for home care services is required for all tele-home-care visits.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Home Care Svcs., As revised Feb. 10, 2021 (Accessed Sept. 2021).
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.
PROVIDER LIMITATIONS
The assessment and monitoring of the health data transmitted by telemonitoring must be performed by the following licensed health care professionals:
OTHER RESTRICTIONS
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.
Independent diagnostic testing facilities are not able to bill for RPM services.
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Sept. 2, 2021. (Accessed Sept. 2021).
Last updated 09/11/2021
Store and Forward
POLICY
“Telehealth” means the delivery of health care services or consultations through the use of real time two-way interactive audio and visual communication 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. 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, e-mail, or facsimile transmission.
SOURCE: MN Statute Sec. 256B.0625 Subd. 3b(1) As Amended by HF 33 (2021 Session). (Accessed Sept. 2021).
MHCP allows payment for store-and-forward.
“Store and Forward”: The asynchronous transmission of medical information to be reviewed at a later time by a physician or practitioner at the distant site. 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, Physician and Professional Services (Telemedicine), As revised Sept. 2, 2021. (Accessed Sept. 2021).
Providers must use the place of service code 02.
Eligible providers:
- 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 requirements and service limitations
- Pharmacist
- Certified genetic counselor
- Podiatrist
- Speech therapist
- physical Therapist
- Occupational therapist
- Audiologist
- Public health nursing organizations
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Sept. 2, 2021. (Accessed Sept. 2021).
ELIGIBLE SERVICES/SPECIALTIES
See Live Video Eligible Services section for examples of eligible telemedicine services as well as noncovered services.
Rehabilitation Services
MHCP allows payment for expanded telemedicine services, including some rehabilitation services that are normally conducted face-to-face. Physical and occupational therapists, speech-language pathologists and audiologists may use telemedicine to deliver certain covered rehabilitation therapy services that they can appropriately deliver via telemedicine. 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 telemedicine services, use place-of-service code 02 to certify that the services meets the telemedicine 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 telemedicine policy by completing the “Provider Assurance Statement for Telemedicine”.
Limited to three sessions per week per recipient. Payment not available for sending materials to a recipient, other providers or other facilities.
Noncovered services:
- 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 telemedicine must follow the same supervision policy as indicated in “Rehabilitation Service Practitioners”. No distant site limitations beyond provider types. See manual for documentation requirements.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Feb. 10, 2021 (Accessed Sept. 2021).
Store-and-Forward Telemedicine for IEP Services
MHCP will allow Minnesota public schools enrolled to provide Individualized Education Program (IEP) services and also approved to provide telemedicine services, to use store-and-forward telemedicine when a child is distance learning at home for the following services:
- Physical therapy
- Occupational therapy
- Speech language therapy
Store-and-forward telemedicine 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) that are necessary to maintain, restore or improve functions related to the child’s disability. Real-time, two-way interactive video with the school professional and child or parent must accompany the store-and-forward telemedicine component.
Use the store-and-forward method only 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.
IEP nursing services, special transportation, assistive technology and personal care assistance (PCA) services are not eligible for store-and-forward telemedicine.
SOURCE: MN Dept. of Human Svcs., Provider Manual, IEP Services, As revised July 22, 2021 (Accessed Sept. 2021).
GEOGRAPHIC LIMITS
Authorized originating sites include:
- 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, shelter or group housing
- 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
- Correctional facility-based office
- Mobile Stroke Unit
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telemedicine), As revised Sept. 2, 2021. (Accessed Sept. 2021).
Dental
Affiliate practice or originator within Minnesota Board of Dentistry defined scope of practice must be present at originating site:
- 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. December 24, 2020 (Accessed Sept. 2021).
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 telemedicine services provided in a private home)
- School
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Feb. 10, 2021 (Accessed Sept. 2021).
TRANSMISSION FEE
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