e-memo

Service Agreement and Claim Date Spans (including discharge date on claim)

Purpose

To inform counties, tribes and SUD residential and inpatient hospital providers about service agreement and claim billing changes.

Action required for county and tribal lead agency

County and tribal agencies entering service agreements for date of service on or after 1/1/2019, must include an extra day at the service agreement header and line level date span to accommodate providers billing for the date of discharge or transfer. The date of discharge or transfer is not reimbursable by MHCP, but must be included on the claim for proper billing.

Example

• The treatment span is 1/1/19 -3/31/19
• The service agreement date header span must be 1/1/19 – 4/1/19.
• The additional authorized day (4/1/19) is not reimbursable but will be included on the final treatment claim as the discharge or transfer day.

Action required for residential and inpatient hospital provider

Effective for date-of-service on or after 1/1/2019, the date of discharge must be included on the final treatment claim along with the appropriate patient status code.

Example 

Service agreement date span is 1/1/19 – 4/1/19. Use interim billing method as follows:

 1^st claim

1. Type of bill 862
2. DOS 1/1/19 – 1/31/19
3. Patient status – 30
4. Covered days – 31

2^nd claim

1. Type of bill 863
2. DOS 2/1/19 – 2/28/19
3. Patient status – 30
4. Covered days – 28

3^rd claim

1. Type of bill 864
2. DOS 3/1/19 – 4/1/19
3. Patient status – 01
4. Covered days – 31 (4/1/19 date is non-covered and considered the discharge day)

*If changes to existing service agreements are required, please contact the authorizing county or tribe to request the change.  

Effective Date

1/1/19

Contact

Send questions pertaining to service agreements to dhs.ccdtf@state.mn.us. Contact the Provider Call Center at (651) 431-2700 for questions related to billing.

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