Targeted case management provider interactive video assurance statement
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Governs requirement for targeted case management (TCM) providers to attest that interactive video is safe and effective for the person served in order to receive Medical Assistance reimbursement for TCM delivered via interactive video. Affects specified TCM provider types in Minnesota.
A completed Targeted Case Management Provider Interactive Video Assurance Statement (DHS-8398) must be on file with DHS for providers to receive Medical Assistance reimbursement for TCM delivered through interactive video beginning May 12, 2023.
Interactive Video Reimbursement Criteria
Interactive video reimbursement criteria
Reimbursement for targeted case management (TCM) delivered via interactive video is permitted only when the provider attests that interactive video is safe and effective for the person served and has the required assurance statement on file with DHS.
ALL of the following
- Provider attests that interactive video is safe and effective for the person served
Attestation per Minnesota Statutes 256B.0625, subdivision 20b
- A completed Targeted Case Management Provider Interactive Video Assurance Statement (DHS-8398) is on file with DHS
DHS-8398 must be submitted/retained in DHS eDocs to qualify for reimbursement
- Effective date: the assurance statement must be on file to receive Medical Assistance reimbursement for TCM delivered through interactive video on or after May 12, 2023May 12, 2023
Applies to the following TCM provider types
- Child Welfare Targeted Case Management (CW-TCM)
- Children's Mental Health Targeted Case Management (CMH-TCM)
- Adult Mental Health Targeted Case Management (AMH-TCM)
- Vulnerable Adult/Developmental Disability Targeted Case Management (VA/DD-TCM)
Billing and Effective Date
| No procedure or billing codes are specified in this notice; requirement pertains to documentation (DHS-8398) for reimbursement of interactive video TCM. |
Assurance Statement Requirement
Submit DHS-8398 assurance statement to qualify for interactive video TCM reimbursement
Providers who choose to deliver Targeted Case Management (TCM) via interactive video must have a completed Targeted Case Management Provider Interactive Video Assurance Statement (DHS-8398) on file with DHS to receive Medical Assistance reimbursement beginning May 12, 2023. The assurance affirms that interactive video is safe and effective for the person served, and must be retained in DHS eDocs per DHS guidance.
- Complete and submit the DHS-8398 form (Targeted Case Management Provider Interactive Video Assurance Statement) and ensure it is on file with DHS.
- Requirement effective for reimbursement of interactive video TCM on or after May 12, 2023.
- Applies to CW-TCM, CMH-TCM, AMH-TCM, and VA/DD-TCM provider types.
Affected Targeted Case Management Providers
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