Telemedicine in Minnesota: Policies
When it comes to telemedicine policy, Minnesota is ahead of the curve in many respects. Its 2015 telehealth parity law mandates reimbursement of telemedicine for private payers and state employee health plans, including dental plans. Minnesota also requires coverage for store-and-forward telemedicine, in contrast to many other states.
Minnesota Parity in coverage and reimbursement
Definition of telemedicine and related terms
Minnesota Statues, section 62A.671, defines telemedicine and related terms for purposes of
the provisions described above. These definitions also have the effect of specifying the covered
modes of telemedicine and the provider types eligible to provide telemedicine services. Some
of the most relevant definitions are summarized below.
Telemedicine is defined as “the delivery of health care services or consultations while the
patient is at an originating site and the licensed health care provider is at a distant site.” Other
components of the definition are that:
- communications between health care providers consisting solely of a telephone
conversation, e-mail, or facsimile transmission are not considered to be a
telemedicine consultation or service;
- communications between a licensed health care provider and a patient consisting
solely of an e-mail or facsimile transmission are not considered to be a telemedicine
consultation or service; and
- telemedicine may be provided by 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.
Distant site is the “site at which a licensed health care provider is located while providing
health care services or consultations by means of telemedicine.”
Originating site means “a site including, but not limited to, a health care facility at which a
patient is located at the time health care services are provided to the patient by means of
telemedicine.”
Medical Assistance Coverage of Telemedicine
Minnesota Statutes, section 256B.0625, subdivision 3b, sets requirements for Medical
Assistance (MA) coverage of telemedicine delivered through the fee-for-service system. These
requirements are described below. A final sub-section describes MA and MinnesotaCare
coverage of telemedicine u
Minnesota Telemedicine Public Health declaration
The public health emergency declared by Governor Walz necessitated the temporary modifications listed in this manual section. Refer to the policy and procedures shown here for changes that we have made to the Medical Assistance and MinnesotaCare programs in relation to COVID-19. Unless expressly listed, all other program requirements continue to apply. All provisions shown here are time-limited. Consult this information regularly for the most up-to-date information.
Minnesota Eligible Telemedicine Providers
Providers Using Telehealth
- • Providers who were already providing traditional telehealth (formerly telemedicine) and have a telehealth assurance statement on file with MHCP with an effective date before Mar. 19, 2020, do not need to submit anything additional and may submit claims for providing telephonic telehealth retroactively to Mar. 19, 2020.
- • Providers who do not have a telehealth assurance statement on file with MHCP, and those that do not meet the standard requirements for traditional telehealth or who do not plan to continue telehealth after the COVID-19 peacetime emergency, must submit the Telephonic Telemedicine Provider Assurance Statement (DHS-6806A) (PDF) for coverage of services via telephone or tele-video. The following applies to the DHS-6806A:
- • Your “Requested Service Effective Date” can be on or after Mar. 19, 2020. If you already submitted DHS-6806A and requested an effective date of Apr. 1, 2020, you do not need to resubmit the DHS-6806A. You can provide telephonic services back to Mar. 19, 2020.
- • Organizational providers may submit one DHS-6806A signed by an authorized representative of the organization; along with a spreadsheet of all providers, including their NPI, affiliated with their practice that will be providing telehealth. Processing telehealth assurance statements is our top priority and the normal 30-day processing timeline should not apply. You can determine if DHS has approved a provider for telehealth without having to wait for claim denials by logging in to your MN–ITS account and accessing the Telehealth/Telephonic Telehealth Provider List from the Provider Lists link. We update the list Monday of each week. View the list using a Chrome or Firefox browser and the Excel XLSX version.
- • Providers who want to continue to provide telehealth services after the peacetime emergency has ended must meet telehealth standard requirements and submit a Telemedicine Provider Assurance Statement (DHS-6806) (PDF).
The Minnesota Legislature approved this policy change to continue. See the IEP Services section of the MHCP Provider Manual.
The commissioner has approved a waiver, effective Nov. 12, 2020, that will temporarily allow MHCP to reimburse for Individualized Education Program (IEP) personal care assistance (PCA) services in a child’s home during distance learning. The child must have a current Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP) based on their current plan of care and time study that identifies the child’s need for the PCA.
Schools should continue to follow the covered and noncovered criteria, recordkeeping and documentation outlined in the IEP Personal Care Assistance (PCA) Services section of the MHCP Provider Manual. Policy coverage did not change.
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