Last updated 06/28/2023
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). (Accessed Jun. 2023).
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. 2023).
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 Mar. 23, 2023. (Accessed Jun. 2023).
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. 2023).
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
- 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 Mar. 23, 2023 & Telehealth Services, As revised Jun. 2, 2023. (Accessed Jun. 2023).
Telehealth does not include:
Non-covered services:
SOURCE: MN Dept. of Human Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Mar. 23, 2023, (Accessed Jun. 2023).
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. 2023).
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. 2023).
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. 2023).
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. 2023).
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. 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 telehealth services provided by the professional provider either employed by or contracted by the school meet all of the conditions of the MHCP telehealth policy by completing the Provider Assurance Statement for Telehealth (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 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. 2023).
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. 2023).
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. If you provide using ITV, submit a claim as a telephone visit. There must be a face-to-face contact in the month preceding the eligible telephone contacts. See manual for examples of CW-TCM activities.
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 Statute 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 in-person visit.
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), June 6, 2023, (Accessed Jun. 2023).
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 telehealth policy by completing the Provider Assurance Statement for telehealth.
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 (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. Aug. 26, 2022 (Accessed Jun. 2023).
Early Intensive Developmental and Behavioral Intervention (EIDBI) services
Telehealth is an option for Early Intensive Developmental and Behavioral Intervention (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
- Intervention- group or individual only (higher intensity intervention sessions cannot occur via telehealth)
- 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, updated Dec. 2022 & MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telehealth Services. Mar. 16, 2022. (Accessed Jun. 2023).
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. 2023).
Rehabilitation Services
MHCP allows payment for some rehabilitation services through telehealth. 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. Must use GT or GQ modifiers. Providers must self-attest that they meet all of the conditions of MHCP telehealth policy by completing the “Provider Assurance Statement for Telehealth”. 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.
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. Jan. 25, 2022 (Accessed Jun. 2023).
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 in the inpatient setting
- Encounters in skilled nursing facilities
- Encounters for MTMS for dual-eligible members
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 Telehealth Provider Assurance Statement (DHS-6806) (PDF) before billing for telehealth MTMS encounters.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Medication Therapy Management Svcs. Nov. 3, 2021 (Accessed Jun. 2023).
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. 2023).
Behavioral Health Home Services
If an individual 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 agreement in place 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, Feb. 23, 2023. (Accessed Jun. 2023).
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) 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, Jun. 28. 2023 (Accessed Jun. 2023).
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. 2023).
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 Senate File 2995 (2023 Session), (Accessed Jun. 2023).
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.
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. A provider must self-attest that they meet all the conditions of the MHCP telehealth policy by completing and submitting the Telehealth Provider Assurance Statement to be eligible for reimbursement.
SOURCE: MN Dept. of Human Services, Telehealth Services Manual, Jun. 2, 2023. (Accessed Jun. 2023).
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 Mar. 23, 2023, (Accessed Jun. 2023).
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 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(d). (Accessed Jun. 2023).
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. 2023).
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. 2023).
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. 2023).
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. 2023).
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, Jun. 2, 2023 (Accessed Jun. 2023).
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 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. 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). 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 (via computer).
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Jan. 25, 2022. (Accessed Jun. 2023).
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. Aug. 26, 2022. (Accessed Jun. 2023).
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. 2023).
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 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. 2023).
Physician and Professional Services
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 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 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 Services, Provider Manual, Physician and Professional Services (Telehealth), As revised Mar. 23, 2023, (Accessed Jun. 2023).
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. 2023)
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.
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, May 19, 2022 (Accessed Jun. 2023)
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. 2023).
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. 2023).
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. Aug. 26, 2022. (Accessed Jun. 2023).
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. 2023).
Tribal Facilities
Outpatient telemedicine services provided through tribal facilities may be paid at the IHS encounter ate or applicable fee-for-service rate. 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. 2023).
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, Jun. 28. 2023 (Accessed Jun. 2023).
GEOGRAPHIC LIMITS
No reference found.
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. 2023).
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 Mar. 23, 2023, (Accessed Jun. 2023).
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. 2023).
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 Senate File 2995 (2023 Session), (Accessed Jun. 2023).
Last updated 06/28/2023
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. 2023).
MHCP allows payment for store-and-forward.
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.
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
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.
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 Mar. 23, 2023 &MN Dept. of Human Services, Provider Manual, Telehealth Services, As revised Jun. 2, 2023. (Accessed Jun. 2023).
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:
Rehabilitation Services
MHCP allows payment for expanded telehealth services, including some rehabilitation services that are normally conducted face-to-face. 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”.
Limited to three sessions per week per recipient. Payment not available for sending materials to a recipient, other providers or other facilities.
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.
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 telehealth must follow the same supervision policy as indicated in “Rehabilitation Service Practitioners”. There are no specific authorized distant sites or restrictions, but providers must ensure a secure transmission that meets HIPAA requirements. See manual for documentation requirements.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Rehabilitation Svcs. Jan. 25, 2022 (Accessed Jun. 2023).
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 telehealth services, to use store-and-forward telehealth when a child is distance learning at home for the following services:
- Physical therapy
- Occupational therapy
- Speech language therapy
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 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 telehealth.
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, IEP Services, As revised May 19, 2022 (Accessed Jun. 2023).
GEOGRAPHIC LIMITS
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
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. Aug. 26, 2022 (Accessed Jun. 2023).
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. Jan. 25, 2022 (Accessed Jun. 2023).
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), Mar 23, 2023. (Accessed Jun. 2023).
