MedicaidAdministrativeHigh impact
System issue affecting certain Early Intensive Developmental and Behavioral Intervention (EIDBI) claims resolved
Minnesota Medicaid (MHCP)·MN · Occupational Therapy, Physical Therapy, Speech Therapy +1 more·Claims & Billing
Effective date
Jan 1, 2025
We identified it
May 20, 2026
Summary
Minnesota Health Care Programs (MHCP) has resolved a system issue that incorrectly denied certain EIDBI claims with an invalid Place of Service 11 edit. Affected claims billed with specific CPT and HCPCS codes with modifier UB for dates of service from January 1, 2025 through May 6, 2026 can now be reprocessed by DHS or resubmitted by providers.
Action Required
Immediately: Billing team must identify all EIDBI claims with CPT codes 0373T, 97151, 97153, 97154, 97155, 97156, 97157, H0032, or T1024 billed with modifier UB for dates of service between January 1, 2025 and May 6, 2026 that were denied with Place of Service 11 edit errors. For each affected claim, providers must decide whether to allow DHS to reprocess the claims automatically or to resubmit claims manually. Contact MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 for guidance on claim status and reprocessing options. Document all actions taken for compliance tracking.