MedicaidAdministrativeMedium impact
Update: Early Intensive Developmental Behavioral Intervention claim denials for Comprehensive Multi-disciplinary Evaluation (CMDE) services (CPT codes 97151 UB, H0046 UB, T1024 UB)
Minnesota Medicaid (MHCP)·MN · Pediatrics, Psychiatry·Claims & Billing
We identified it
May 26, 2026
Summary
Minnesota Health Care Programs (MHCP) has resolved a system issue that was incorrectly denying Comprehensive Multi-disciplinary Evaluation (CMDE) claims for specific CPT codes when billed with pay-to provider types 01 or 34. MHCP will automatically reprocess affected claims; no action is required from providers at this time. Billing teams should monitor remittance advices for reprocessed claims.
Action Required
No immediate action required. Billing team should: (1) Monitor remittance advices for reprocessed CMDE claims with CPT codes 97151, H0046, and T1024; (2) Track any credits or adjustments related to previously denied claims; (3) Contact MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if questions arise about specific claim reprocessing or if denied claims do not appear to be reprocessed within a reasonable timeframe. Update internal records to document this system issue resolution for future reference when CMDE claims are submitted.