Minnesota Medicaid Mental Health Claims and Telehealth

Updated October 9, 2026.

For Minnesota mental-health claims, first establish who is responsible for the service on the date of care. MHCP fee-for-service (FFS) billing and an assigned managed-care plan’s billing are separate workflows. The checklist below is checked October 9, 2026 and focuses on professional outpatient mental-health services. MHCP billing overview.

Start each visit with MN–ITS eligibility verification; use LoginMN account setup if transaction access is missing.

Choose FFS or the member’s health plan before submitting

Use MHCP’s FFS instructions when the service is payable through FFS. For a managed-care member, check the plan’s service-specific claims and authorization instructions, including any applicable exceptions. Review other insurance and coordination of benefits before submission. MHCP billing policies.

For former UCare Medicaid members, Medica’s claims transition page identifies October 1, 2026 as the move to Medica claims submission and payment. Confirm the current product-specific route; do not apply the different Individual and Family plan timeline to Medicaid. Medica transition claims guidance.

Check enrollment and psychotherapy documentation

Verify the billing group, rendering clinician and relevant affiliation through the MHCP enrollment workflow and confirm any separate plan participation.

MHCP psychotherapy policy specifies eligible professionals and clinical trainees, medical necessity, assessment and treatment-plan requirements, and session documentation. Use the policy for the service actually delivered. Clinical trainee services have supervision requirements; an enrolled group does not remove them. MHCP psychotherapy policy.

For other services such as diagnostic assessment or specialized community mental-health treatment, use that service’s own policy rather than treating all behavioral health as psychotherapy. MHCP mental health service index.

FFS telehealth: assurance, patient location and audio-only

Have an approved Telehealth Provider Assurance Statement (DHS-6806) on file with MHCP for reimbursement. For professional FFS claims, use the appropriate procedure code on an 837P claim, with place of service 10 when the patient is at home or 02 elsewhere. Audio-only billing uses modifier 93. MHCP telehealth billing policy.

The current policy includes audio-only communication until July 1, 2027. It requires a scheduled appointment and the applicable standard of care, with an exception for member-initiated mental-health or substance-use emergency/crisis care needing an immediate response. Audio-only coverage conditions.

Authorization requirements still apply when required for the underlying service. Document the service, start and stop time, modality, clinical appropriateness, and originating and distant locations. Check service-specific and MCO billing instructions rather than treating these FFS fields as a universal plan recipe. Telehealth documentation and authorization.

Do not use interactive complexity for connection problems

MHCP explicitly says technical difficulties with telehealth alone do not justify interactive complexity. Choose coding from the clinical service and qualifying circumstances, not from the inconvenience of reconnecting a call. Psychotherapy interactive-complexity guidance.

Reconcile the result before resubmitting

• Keep the claim submission result and review its status and remittance information.

• Separate an eligibility or payer-routing issue from a provider-record, authorization or claim-field issue.

• Use the applicable MHCP or plan correction instructions rather than repeatedly submitting an unchanged claim.

• For payment setup after an approved state claim, review the separate MMB supplier record.

Use the MHCP billing overview for FFS claim handling and the plan’s current instructions for managed care. The MMB supplier ID guide explains state payment setup.

How Bomi can help

Bomi can help organize enrollment, payer follow-up and billing work. If you want help with your Minnesota workflow, contact Bomi and identify the task that is blocked.

Related Minnesota guides

Current MHCP plans and credentialing. MN–ITS/MPSE access for Bomi.

Frequently Asked Questions

Does every Minnesota Medicaid mental-health claim go to MN–ITS?

No. Determine FFS versus managed-care responsibility and the service-specific rules for the member and date of care before selecting a claim destination.

Which place of service does MHCP FFS telehealth use?

The current professional FFS guidance uses 10 for the patient’s home and 02 for another location. Check the policy and service-specific requirements before billing.

Can an internet problem justify interactive complexity?

No. MHCP psychotherapy guidance says technical telehealth difficulties alone do not justify interactive complexity.