MA Billing
Archived COVID-19 Page
Explanation
The Minnesota Department of Human Services continues to update their MHCP (MA Billing) manual regarding how schools should proceed with MA billing during the pandemic. The information on this page will include highlights from the updates as well as frequently asked questions.
Telemedicine*
Telemedicine
Until further notice, Minnesota Health Care Programs (MHCP) is temporarily expanding coverage of telemedicine visits.
The following changes are effective for dates of service on and after Mar. 19, 2020, for eligible providers who render services via telemedicine:
Eligible providers can provide services virtually via telephone when providers determine it is safe and effective to do so. This coverage change applies to MHCP members in fee-for-service programs.
The current limitation of three telemedicine encounters per week is suspended.
MHCP will cover evaluation and management services provided via telephone using the telephone services CPT codes. Follow CPT guidelines for use of 99441, 99442 and 99443.
In delivering telemedicine, including via telephone, the distant site (provider’s location) can be the eligible provider’s home. The originating site (member’s location) can be delivered to members while they are in their home.
Also refer to the Telemedicine Delivery of Mental Health Services section of this manual.
For more details about expanded use of telemedicine for substance use disorder (SUD) and mental health services, see the Temporary coverage of telemedicine visits for substance use disorder (SUD) and mental health providers webpage.
Store-and-Forward Telemedicine for IEP Services
Effective Aug. 1, 2020, MHCP will allow Minnesota public schools enrolled to provide Individualized Education Program (IEP) services and also approved to provide telemedicine services, to use store-and-forward telemedicine when a child is distance learning at home for the following services:
Physical therapy
Occupational therapy
Speech language therapy
Store-and-forward telemedicine is asynchronous, non-real-time communications. Data is transferred from one site to another through the use of a camera or similar device that records (stores) an image that is sent (forwarded) via telecommunications to another site for consultation. It can be used to support health care delivery, including sending and receiving health-related instructions, activities or tasks that are identified in the child’s Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP) that are necessary to maintain, restore or improve functions related to the child’s disability. To be reimbursed by MHCP, the store-and-forward telemedicine component must be accompanied by some real-time, two-way interactive video with the school professional and child or parent.
The store-and-forward method can only be used when a child is distance learning at home. When a child is attending school in person, IEP services must be provided either in person, or via two-way interactive video conference.
IEP nursing services, special transportation, assistive technology and personal care assistance (PCA) services are not eligible for store-and-forward telemedicine.
This waiver will remain in effect until the end of the public health emergency, or July 1, 2021, whichever comes later.
Store and Forward Documentation Example
Store and Forward Documentation EXAMPLE 10.16.20 JR.pdfFrequently Asked Questions
With the changing learning models, how should time studies be completed?
In-Person:
If you are in-person but you are unable to gather new data this year due to staff shortages, or other reasons, time study data from last year can be used if the following conditions are met:
Qualified Professional(s) verifies the data is still representative of the student's needs
Written signatures are gathered from those supporting the student this year to verify the accuracy
Information is communicated with district/building MA staff member
If any of the conditions are not met, new time studies will need to be completed.
Hybrid:
If your district started in Hybrid, the 10-day time study still must be completed, but will take longer, due to any reduction in on-site/in-person learning.
If your district switches to hybrid, but a 10-day time student was completed prior to the change, a new time study is NOT needed. The average daily time that gets billed based on the 10-day time study will need to be reduced to reflect the new schedule. If the length of the day is shortened, then the average daily time for that task should be reduced by the same percentage. If the child is not on-site, then no billing can occur on that day.
Distance Learning:
If your district switches to distance learning, or if the student has chosen distance learning, time studies cannot be completed. Billing may happen for other services (OT, PT, Speech, etc) but PCA services are not applicable.
If I am providing speech, OT, or PT services via Google Meet, Zoom, or other video conference platform with a student, can I bill for this time?
Yes. During the pandemic, telemedicine practices are being expanded to allow school districts to bill for services provided via technology to students. If students are in-person, billing can occur for services that are done synchronously. If students are in distance learning, billing can occur for services that done synchronously or asychronously (see details under Store-And-Forward above).