Last updated 02/28/2021
Live Video
POLICY
Medical assistance covers medically necessary services and consultations delivered by a licensed health care provider via telemedicine in the same manner as if the service was delivered in-person. Coverage is limited to three telemedicine services per week per enrollee. Telemedicine services are paid at the full allowable rate.
SOURCE: MN Statute Sec. 256B.0625, Subdivision 3b(a) (Accessed Feb. 2021).
- The limit of coverage of three telemedicine services per enrollee per calendar week does not apply if:
- The telemedicine services are for the treatment and control of tuberculosis; and
- The telemedicine services are provided in a manner consistent with the recommendations and best practices specified by the Centers for Disease Control and Prevention and the commissioner of health.
SOURCE: MN Statute Sec 256B.0625, Subdivision 3b. (Accessed Feb. 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 Jan. 28, 2020. (Accessed Feb. 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. Payment is not available for sending materials to a recipient, other provider or facility. See Live Video Policy section above for exception or tuberculosis control and treatment.
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 Jan. 28, 2020. (Accessed Feb. 2021).
Mental Health Services
Mental health services that are otherwise covered by medical assistance as direct face-to-face services may be provided via two-way interactive video. Use of two-way interactive video must be medically appropriate to the condition and needs of the person being served. Reimbursement is at the same rates and under the same conditions that would otherwise apply to the service. The interactive video equipment and connection must comply with Medicare standards in effect at the time the service is provided.
SOURCE: MN Statute Sec. 256B.0625, Subd. 46 (Accessed Feb. 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 Feb. 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 Feb. 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 4/10/2020 (Accessed Feb. 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 Feb. 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 Feb. 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 Feb. 2021).
Early Intensive Developmental and Behavioral Intervention (EIDBI) EIDBI services
Telemedicine is an option for Early Intensive Developmental and Behavioral Intervention (EIDBI) EIDBI services. Either the person or his/her family must be present via two-way interactive video while the provider delivers EIDBI telemedicine 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, January 2021 (Accessed Jan. 2021) & MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telemedicine Services. July 1, 2020. (Accessed Feb. 2021).
Medical assistance covers medically necessary EIDBI services and consultations delivered by a licensed health care provider via telemedicine, in the same manner as if the service or consultation was delivered in person.
SOURCE: MN Statute Sec. 256B.0949, Subdivision. 13. (Accessed Feb. 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. Sept. 18, 2020 (Accessed Feb. 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 Feb. 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 Jan. 28, 2020. (Accessed Feb. 2021).
Medical assistance covers medically necessary services and consultations delivered by a licensed health care provider via telemedicine, which includes a licensed health care provider under section 62A.671, subdivision 6, a community paramedic as defined under section 144E.001, subdivision 5f, or a mental health practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision 26, working under the general supervision of a mental health professional, and a community health worker who meets the criteria under subdivision 49, paragraph (a).
SOURCE: MN Statute Sec. 256B.0625, Subd. 3b. (Accessed Feb. 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 April 10, 2020. (Accessed Feb. 2021).
Early Intensive Developmental and Behavioral Intervention (EIDBI) EIDBI services
Eligible Providers:
- Physician
- Nurse practitioner
- Clinical psychologist
- Clinical social worker
- Speech therapist
- Physical therapist
- Occupational therapist.
Mental health practitioners working under the supervision of a mental health professional are also eligible. A comprehensive multi-disciplinary evaluation provider, qualified supervising professional, (Level I or Level II) EIDBI provider may apply to provide EI DBI services via telemedicine if they meet the qualifications and complete the Telemedicine Assurance Statement.
SOURCE: MN Dept. of Human Services, EIDBI Benefit Policy Manual, EIDBI Telemedicine Services. July 1, 2020. (Accessed Feb. 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 Feb. 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. Individual, non-residential treatment is the only substance use disorder service currently reimbursed via telemedicine.
SOURCE: MN Dept. of Human Svcs., Provider Manual, Substance Use Disorder Telemedicine, Oct. 19, 2017 (Accessed Feb. 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. Sept. 18, 2020 (Accessed Feb. 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 Jan. 28, 2020. (Accessed Feb. 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, April 10, 2020 (Accessed Feb. 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 Feb. 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 Feb. 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 Feb. 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. Sept. 18, 2020 (Accessed Feb. 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., Nov. 22, 2019 (Accessed Feb. 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 Feb. 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 1, 2020. (Accessed Feb. 2021).
Last updated 02/28/2021
Store and Forward
POLICY
Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care.
SOURCE: MN Statute Sec. 256B.0625 Subd. 3b(d) (Accessed Feb. 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 Jan. 28, 2020. (Accessed Feb. 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 Jan. 28, 2020. (Accessed Feb. 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 Feb. 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 Jan. 28, 2020. (Accessed Feb. 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 Feb. 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 Feb. 2021).
TRANSMISSION FEE
No Reference Found
