Minnesota State Telehealth Laws and Reimbursement Policies

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Information Provided ByCenter for Connected Health Policy

© Public Health Institute/ Center for
Connected Health Policy 2019: http://cchpca.org

Medical Assistance (MA)

Minnesota
Medicaid Program: Medical Assistance (MA)

Program Administrator: MN Dept. of Human Services

Regional Telehealth Resource Center:

Great Plains Telehealth Resource and Assistance Center
University of Minnesota/Institute for Health Informatics

330 Diehl Hall
505 Essex Street S.E.
Minneapolis, MN 55455

(888) 239-7092
www.gptrac.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth

“Telemedicine” means the delivery of health care “Telemedicine is defined as the delivery of health care
services or consultations while the patient is at an services or consultations while the patient is at an
originating site and the licensed health care provider is originating site and the licensed health care provider is
at a distant site. A communication between licensed at a distant site.”
health care providers that consists solely of a telephone
conversation, e-mail, or facsimile transmission does not Source: MN Dept. of Human Services, Provider Manual, Physician
constitute telemedicine consultations or services. A and Professional Services, As revised Oct. 28, 2017. (Accessed
communication between a licensed health care provider Oct. 2017).

and a patient that consists solely of an e-mail or
facsimile transmission does not constitute telemedicine
consultations or services. 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 Senate File 1458 (2015). MN Statute Sec 256B.0622,
subdivision 8 & 147.033 (SF 1353).

Live Video Reimbursement

Intensive Rehabilitative Mental Health Services Minnesota’s Medical Assistance program reimburses
Physician services may be billed by a psychiatrist or live video for fee-for-service programs.
other health care professional to treat intensive
residential treatment services. To be eligible for reimbursement, providers must self-
attest that they meet the conditions of the MHCP
Source: MN Senate File 1458 (2015). MN Statute Sec 256B.0622, telemedicine policy by completing the Provider
subdivision 8. Assurance Statement for Telemedicine form.
(see Medicaid column) Providers must use the new place of service code 02

beginning Nov. 1, 2017. Modifiers GT and GQ are still
also required.
Eligible providers:

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STATE LAW/REGULATIONS MEDICAID PROGRAM

Physician

Nurse practitioner

Physician assistant

Nurse midwife

Clinical nurse specialist

Registered dietitian or nutrition professional

Clinical psychologist

Clinical social worker

Dentist, dental hygienist, dental therapist,

advanced dental therapist

Mental health professional, when following

requirements and service limitations

Pharmacist

Certified genetic counselor

Podiatrist

Speech therapist

Therapist

Occupational therapist

Audiologist

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 may be billed

when no physician is in the ER and the nursing staff is
caring for the patient at the originating site.

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.

Non-covered services:

Electronic connections that are not conducted

over a secure encrypted website as specified by

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

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
Source: MN Dept. of Human Services, Provider Manual, Physician
and Professional Services, As revised Oct. 28, 2017. (Accessed
Oct. 2017).
Some mental health services may be covered by
telemedicine.
Source: MN Dept. of Human Svcs., Provider Manual, Telemedicine
Delivery of Mental Health Services, Dec. 15, 2015 (accessed Oct.
2017).
Individualized Education Program (IEP)
Eligible originating sites:
Home
School
Telemedicine coverage applies to a child or youth who is
MA eligible, has an IEP and the service provided is
identified in the IEP.
To be eligible for reimbursement, the school or school
district must self-attest 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).
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
Non-Covered Services
Services that are less effective than if provided

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STATE LAW/REGULATIONS MEDICAID PROGRAM

in person, face-to-face

Supervision evaluations or visits
Evaluations or assessments
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
See IEP manual for specific documentation and billing
requirements.
Source: MN Dept. of Human Svcs., Provider
Manual, Individualized Education Program, May 23, 2016
(accessed Oct. 2017).
Telemedicine consults shall be paid at the same rate as
in-person services.
Minnesota Source: MN Statute Sec. 256B.0625
Non-covered Services
Telemedicine for alcohol and drug abuse
services
Source (Alcohol and drug abuse): MN Dept. of Human Svcs.,
Provider Manual, Alcohol and Drug Abuse Svcs. Jul. 10, 2017
(Accessed Oct. 2017).
Teledentistry services through real time audio and video
is allowed.
Source (dental): MN Dept. of Human Svcs., Provider Manual,
Dental Svcs. May 25, 2017 (Accessed Oct. 2017).
Telemedicine is an option for Early Intensive
Developmental and Behavioral Intervention (EIDBI)
EIDBI services.
Limited to three telemedicine services per person per
calendar week.
Source (dental): MN Dept. of Human Svcs., Provider Manual,
EIDBI Svcs. Jun. 14, 2017 (Accessed Oct. 2017) & MN Statute
256B.0949.
MHCP allows payment for some rehabilitation services
through telemedicine. Providers must self-attest that
they meet all of the conditions of MHCP telemedicine

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STATE LAW/REGULATIONS MEDICAID PROGRAM

policy by completing the “Provider Assurance Statement

for Telemedicine”.
Source: MN Dept. of Human Svcs., Provider Manual,
Rehabilitation Svcs. Aug. 3, 2016 (Accessed Oct. 2017).

Store and Forward Reimbursement

(see Medicaid column) Minnesota’s Medical Assistance program reimburses for
services delivered through store and forward
technology.
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 recipients, other providers or facilities.
Source: MN Dept. of Human Services, Provider
Manual, Physician and Professional Services, As revised Oct. 28,
2017. (Accessed Oct. 2017).
Store and forward technology includes telemedicine
consults that do not occur in real time, and that do not
require a face-to-face encounter with the patient for all
or any part of the consult.
Source: MN Statute Sec. 256B.0625 (2012).
Teledentistry services through store and forward is
allowed.
Source (dental): MN Dept. of Human Svcs., Provider Manual,
Dental Svcs. May 25, 2017 (Accessed Oct. 2017).

Remote Patient Monitoring Reimbursement

No reference found. There is reimbursement for “telehomecare” under
Elderly Waiver (EW) and Alternative Care (AC)
programs.
Not covered under PERS
Source: MN Dept. of Human Svcs., Provider Manual, Elderly
Waiver (EW) and Alternative Care (AC) Program, As revised Jul.
7, 2016, (Accessed Oct. 2017).
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 Jan. 23, 2015 (Accessed Oct. 2017).

Email/Phone/FAX

No reference found. No reimbursement for email
No reimbursement for phone
No reimbursement for fax
Source: MN Dept. of Human Services, Provider Manual, Physician

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

and Professional Services, As revised Oct. 28, 2017. (Accessed
Oct. 2017).
“A communication between two physicians that consists
solely of a telephone conversation is not a telemedicine
consultation.”
Source: MN Statute Sec. 256B.0625 (2012).
Case management for Child Welfare Case Management
services is covered through telephone.
Source: MN Dept. of Human Svcs., Provider Manual, Child
Welfare Case Management Services, As revised Jul. 17, 2017.
(Accessed Oct. 2017).

Online Prescribing

Recently Passed Legislation (Now Effective) No reference found.
A physician patient relationship may be established
through telemedicine.
Source: MN Statute 147.033 (SF 1353).
A prescription or drug order is not valid unless it can be
established that the prescription or order was based on
a documented patient evaluation, including an
examination, adequate to establish a diagnosis and
identify underlying conditions and contraindications to
treatment.
This includes the referring provider performing an in-
person examination and a consultant issuing the
prescription when providing services by telemedicine.
Source: MN Statute Sec. 151.37(2012).

Consent

No reference found. No reference found.

Location

No reference found. 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

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

delivery of telemedicine services provided in a
private home)
School
Out-of-state coverage policy applies to services
provided via telemedicine. 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 Services, Provider Manual, Physician
and Professional Services, As revised Oct. 28, 2017. (Accessed
Oct. 2017).

Cross-State Licensing

A physician licensed in another state can provide No reference found.
telemedicine services to a patient in Minnesota if their
license has never been revoked or restricted in any
state, they agree to not open an office in Minnesota and
they register with the state’s board.
Source: MN Statute Sec. 147.032(1)
Minnesota adopted the Federation of State Medical
Board (FSMB)’s model language for an interstate
medical licensure compact.
Source: MN Senate File 253 (2015). MN Statute Sec. 147.38.

Private Payers

Private payers are required to provide coverage for No reference found.
telemedicine in the same manner, and at the same
reimbursement rate, as other services provided in
person. (Applies to plans that begin on or after Jan. 1,
2017).
A health carrier can establish criteria that a health care
provider must meet to demonstrate the safety or efficacy
of delivering a service via telemedicine. They can also
require a health care provider to agree to certain
documentation or billing practices to protect against
fraud.
Source: MN Senate File 1458 (2015). MN Statute Sec. 62A.672.

Site/Transmission Fee

No reference found. No reference found.

Miscellaneous

The Chemical Dependency Continuum of Care Pilot
Project is to include telehealth services to address
barriers to services.
Source: MN Statute 254B.14 Sec. 13

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