Minnesota Billing Guide for Mental Health Therapists and Psychiatrists
Who pays, where to enroll and which rules change your claims in Minnesota, for psychotherapists and psychiatric prescribers.
Last checked October 25, 2026. Reviewed against the official sources listed at the bottom of this page.
This Minnesota billing guide covers Medicaid, Medicare, Blue Cross, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
Minnesota billing guide: how Minnesota pays for outpatient care
Minnesota's Medicaid program is called Medical Assistance, and with MinnesotaCare it makes up Minnesota Health Care Programs (MHCP), run by the Department of Human Services (DHS). Members are served by managed care plans and fee-for-service. Fee-for-service claims go through MN-ITS, and enrollment goes through the MPSE portal.
Counties act as the local mental health authority, and some services need county contracts or certification. Licensed clinicians such as LICSWs, LMFTs, LPCCs, psychologists, psychiatrists and nurse practitioners can enroll with MHCP, but mental health practitioners and clinical trainees cannot.
Who to bill, at a glance
| Payer type | Who you bill | Where to enroll or check rules |
|---|---|---|
| Medicaid (MHCP) | Minnesota DHS; managed care plans and fee-for-service; MN-ITS and MPSE | Enroll with MHCP |
| Medicare Part B | National Government Services, Jurisdiction 6 | CMS MAC page |
| Blue Cross Blue Shield | Blue Cross and Blue Shield of Minnesota (independent, not Anthem) | See the Blue Cross section below |
Minnesota Medicaid: Minnesota Health Care Programs
This Minnesota billing guide starts with Medicaid, because it decides who pays and how you file.
Managed care (the Prepaid Medical Assistance Program, MinnesotaCare, Minnesota Senior Care Plus and plans for seniors and people with disabilities) runs alongside fee-for-service coverage. DHS runs an annual health plan selection each fall. Providers can enroll for managed care members only, fee-for-service only, or both.
No statewide behavioral health carve-out vendor turned up in the DHS sources we reviewed. Confirm how each plan handles behavioral health benefits before you bill.
| Item | What to know |
|---|---|
| Agency | Minnesota Department of Human Services |
| Provider manual | MHCP Provider Manual, including Mental Health Services |
| Enrollment | Enroll with MHCP |
| Prior authorization | DHS says standard requests get initial action within five business days and expedited requests within 48 hours. Acentra Health reviews requests as the medical review agent. Denials can be appealed within 60 days. Source |
| Fee-for-service filing window | Medical Assistance claims are due no later than 12 months after the date of service under Minn. R. 9505.0450. Check the current rule text on the Revisor of Statutes site. |
| Work requirement | DHS says requirements begin January 1, 2027 for adults in the expansion group, generally ages 21 to 64, and that final federal guidance is pending. Affected people generally renew every six months. Exemptions include people with certain serious or chronic conditions and people in substance use treatment. Source |
Managed-care plans and carve-outs
| Plan or entity | Role in behavioral health |
|---|---|
| Blue Plus | Blue Cross and Blue Shield of Minnesota subsidiary, listed for the Prepaid Medical Assistance Program and MinnesotaCare. |
| HealthPartners | Listed on the DHS 2027 plan selection page. |
| Hennepin Health | Listed on the DHS 2027 plan selection page. |
| Itasca Medical Care | Listed on the DHS 2027 plan selection page. |
| Medica | Listed on the DHS 2027 plan selection page. DHS says Medica is acquiring certain UCare contracts and assets. |
| PrimeWest Health | Listed on the DHS 2027 plan selection page. |
| South Country Health Alliance | Listed on the DHS 2027 plan selection page. |
Check the DHS plan selection page for the current roster, and the DHS bulletin on UCare and Medica for contract changes.
Medicare Part B in Minnesota
For Medicare, this Minnesota billing guide names your contractor and the current telehealth rules.
Medicare Part B pays for outpatient psychotherapy and psychiatric visits billed to the Medicare Administrative Contractor (MAC) for your state. CMS's July 14, 2026 fact sheet on the CY2027 Physician Fee Schedule proposed rule says the Consolidated Appropriations Act, 2026 extended telehealth payment authority through December 31, 2027, and proposes that in-person visit requirements for mental health visits not apply to services furnished through that date.
| Item | What to know |
|---|---|
| Contractor | National Government Services, Inc. |
| Jurisdiction | Jurisdiction 6: Illinois, Minnesota and Wisconsin |
| Source | CMS.gov MAC page |
Blue Cross Blue Shield in Minnesota
This part of the Minnesota billing guide names the exact Blue Cross licensee, because Blue plans never share rules.
Blue Cross Blue Shield is a federation of independent companies, so one licensee's rules never apply to another. In Minnesota that is Blue Cross and Blue Shield of Minnesota, with Blue Plus as its Medicaid subsidiary. The Blue Cross and Blue Shield Association lists it as the Minnesota company. It is not part of Elevance Health and is not Anthem. Do not apply another state's Blue rules to Minnesota.
| Licensee | Parent or affiliation | Where it applies | Provider resources |
|---|---|---|---|
| Blue Cross and Blue Shield of Minnesota | Independent; Blue Plus is its nonprofit subsidiary | All 87 Minnesota counties, per a 2025 Blue Cross handout | Blue Cross Minnesota |
Other private payers and EAPs in Minnesota
The Minnesota billing guide also covers commercial plans and employee assistance programs.
These commercial payers and plan families most often matter for behavioral health billing in Minnesota. Check each payer's current provider manual before you submit.
| Payer | Behavioral health note | Provider resources |
|---|---|---|
| Blue Cross and Blue Shield of Minnesota | Provider notice P74-22 sets the timely filing limit at 180 days for all lines of business from February 1, 2023, with a 90-day appeal window. | Official page |
| Medica | DHS names Medica in its plan selection and acquisition bulletins. Check Medica for commercial behavioral health billing rules. | Official page |
| Cigna / Evernorth Behavioral Health | The Evernorth administrative guide prefers electronic claims and says EAP claims must use CPT 99404. | Official page |
Minnesota billing guide: state law that changes billing
Use this section of the Minnesota billing guide to separate state law from payer policy.
State law sets the floor for commercial plans in Minnesota. Medicare and Medicaid rules are covered in their own sections above.
Mental health parity
Minn. Stat. 62Q.47 says cost-sharing and limits for mental health and chemical dependency services may not be heavier or more restrictive than for medical care, and plans may not impose a nonquantitative treatment limit unless it is comparable to, and no more stringent than, those for medical and surgical benefits. Therapy and medication maintenance visits count as primary care visits for cost-sharing. Statute
Telehealth coverage and payment parity
Minn. Stat. 62A.673 requires health plans to reimburse telehealth on the same basis and at the same rate as in-person services, with cost sharing no higher than in person. It does not apply to enrollees of public health care programs. Check the statute for the current audio-only rule. Statute
Prompt payment and timely filing
Minn. Stat. 62Q.75 requires providers to submit charges to the plan within six months of the date of service unless the contract or other law provides otherwise, and requires payers to pay or deny clean claims within 30 calendar days of receipt. Late-payment interest is 1.5 percent per month. Statute
Practitioner scope: therapists and prescribers
DHS says licensed LICSW, LMFT, LPCC, licensed psychologists, psychiatrists, nurse practitioners and clinical nurse specialists in mental health may enroll with MHCP. Mental health practitioners, peer specialists, case managers and clinical trainees may deliver services but cannot enroll. Source
Not legal advice. Confirm statute details with counsel.
Minnesota billing guide: codes and rates
This Minnesota billing guide lists only codes and rates confirmed on official pages.
These are the Minnesota-specific codes, modifiers and rate items confirmed on official pages. Medicare's own CY2027 conversion factor proposal is listed under What changed.
| Code or item | What to know |
|---|---|
| Telehealth place of service and modifiers | The DHS telehealth manual page says to use place of service 02 (not at home) or 10 (home). Modifier 93 is required for audio-only. Telehealth modifiers without POS 02 or 10 deny, and a Telehealth Provider Assurance Statement (DHS-6806) must be on file. The page is dated October 2022, so recheck it. Source |
| Time-based codes | Time-based codes follow CPT and HCPCS rules. Spend more than half of a time unit to bill it. Remaining time cannot be billed separately. Source |
| Fee-for-service rates | See the DHS payment rates page for current mental health rates. |
Minnesota billing guide: what changed, newest first
Check this Minnesota billing guide update log before you rely on an older rule.
| Date | What changed | Source |
|---|---|---|
| 2027-01-01 | Medicaid work requirement starts for the expansion group. | Source |
| 2026-08-27 | DHS revised the MHCP Mental Health Services manual page. | Source |
| 2026-07-31 | DHS revised the MHCP Authorization page. | Source |
| 2026-07-14 | CMS released the CY2027 Medicare Physician Fee Schedule proposed rule: conversion factor $32.84 for non-qualifying APM participants (down 1.68%) and $33.17 for qualifying participants (down 1.19%). | Source |
| 2026-06-15 | DHS updated its work requirement page. Final federal guidance is pending. | Source |
| 2026-01-01 | Medica acquires certain UCare contracts and assets. UCare MSHO and integrated plans for people with disabilities ended 12/31/2025. | Source |
How do I bill mental health claims in Minnesota?
These answers come from the same sources as the rest of this Minnesota billing guide.
Start with the member's payer type. For Minnesota Medical Assistance, bill the member's managed care plan, or MN-ITS for fee-for-service, after enrolling with MHCP. Medicare Part B goes to National Government Services in Jurisdiction 6. Blue Cross and Blue Shield of Minnesota is an independent Blue licensee and is not Anthem.
Questions about billing in Minnesota
Who do I bill for Minnesota Medical Assistance behavioral health claims?
Bill the member's managed care plan, or use MN-ITS for fee-for-service. Enroll with MHCP first.
What is the Minnesota commercial timely filing rule?
Minn. Stat. 62Q.75 requires providers to submit charges within six months of the date of service unless the contract says otherwise. Blue Cross and Blue Shield of Minnesota sets 180 days.
Which clinicians can enroll with MHCP?
Licensed LICSW, LMFT, LPCC, psychologists, psychiatrists, nurse practitioners and clinical nurse specialists in mental health. Clinical trainees and mental health practitioners cannot enroll.
Does Minnesota require telehealth payment parity?
Minn. Stat. 62A.673 requires commercial plans to reimburse telehealth at the same rate as in person. It does not apply to public program enrollees.
Does MCM South bill for practices in Minnesota?
MCM South currently serves ten states; request a quote to ask about Minnesota.
Sources for the Minnesota billing guide
Last checked October 25, 2026. Every source below was opened and read on that date.
- Minnesota DHS, checked October 25, 2026
- MHCP Provider Manual, checked October 25, 2026
- MHCP Mental Health Services, checked October 25, 2026
- MHCP telehealth delivery of mental health services, checked October 25, 2026
- MHCP authorization, checked October 25, 2026
- Enroll with MHCP, checked October 25, 2026
- DHS annual health plan selection, checked October 25, 2026
- DHS work requirement key messages, June 2026, checked October 25, 2026
- DHS bulletin on UCare and Medica, checked October 25, 2026
- Blue Cross Minnesota notice P74-22, checked October 25, 2026
- Minn. Stat. 62Q.47, checked October 25, 2026
- Minn. Stat. 62Q.75, checked October 25, 2026
- Minn. Stat. 62A.673, checked October 25, 2026
- CMS: MAC Jurisdiction 6, checked October 25, 2026
- CMS: CY2027 Physician Fee Schedule proposed rule fact sheet, checked October 25, 2026
- CMS MAC jurisdiction page, checked October 25, 2026
Related guides
- State & Regional Billing Guides hub
- In-network vs out-of-network credentialing
- Credentialing and network status
- Blue Cross Blue Shield guide for Minnesota
- Mental health parity explained
- Medicaid managed care billing
- Medicare behavioral health billing
- Timely filing in the billing glossary
- Who we serve
- Illinois insurance companies contact guide
- Colorado insurance companies contact guide
Billing in Minnesota? Let us handle the payer calls.
MCM South bills only mental and behavioral health, for psychotherapists and psychiatrists, in solo and medium-size practices. We currently serve ten states; request a quote to ask about Minnesota.
MCM South currently serves practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.