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Updates on claim payment for UCare Individual and Family Plans: Greater transparency in MinnesotaCare tax payments
UCare will begin reporting tax as its own adjustment on UCare Individual and Family Plans claims effective with Jan. 1, 2025, dates of service.
March 2025 Health Lines
Learn about the following: 2025 UCare Provider Manual released, UCare's provider training series, documentation compliance, Colorectal Cancer Awareness Month, Disease Management overview, weight management program: Cecilia Health weight management virtual support program, dental care on the move, connecting members to dental care, dental kits, fraud, waste and abuse reporting and more.
New Minnesota provider qualifications for Board-Certified Behavior Analysts (BCBA) requires licensing by state
Effective Jan. 1, 2025, Minnesota state law updated provider qualifications for BCBAs requiring them to be Licensed Behavioral Analysts (LBA). BCBAs are now required to be independently licensed and enrolled in Minnesota Health Care Programs (MHCP). As a result of the change, BCBA providers also must be credentialed with UCare to see UCare members.
2025 Q1 UCare Provider Manual Released
The Q1 UCare Provider Manual was updated to reflect current business practices.
Visit the UCare Provider Manual page for the most up-to-date version.
Durable Medical Equipment (DME) unlisted or enhanced items and supplies reimbursement to change
Effective April 1, 2025, providers who bill for unlisted or enhanced DME equipment and supply HCPCS codes submitted with a U3 modifier for UCare Minnesota Health Care Program (MHCP) members will receive new reimbursement rates.For details, see the Jan. 29 Provider Bulletin.
Medical Assistance (Medicaid) providers required to enroll with Minnesota Health Care Programs (MHCP) – Deadline extended for provider types requiring MHCP site visits
The 21st Century Cures Act requires states to enroll all Medical Assistance (Medicaid) providers. UCare providers who are contracted to provide services to Medical Assistance members are expected to enroll with MHCP, except for certain provider types that require a site visit from the Minnesota Department of Human Services (DHS) first. DHS has extended the enrollment requirement date to April 30, 2025, for these provider types. MHCP will conduct an announced site visit within 60 days of the referral date for the providers. These providers must complete both the enrollment process and site visit by April 30, 2025.
See the Jan. 28 Provider Bulletin for a list of provider types with an extension.
Tips and reminders regarding Nursing Facility Liability Letters
Learn more about when UCare is responsible for skilled nursing facility or nursing facility services and the Nursing Facility Liability Letter process.
See the Jan. 22 Provider Bulletin for details.
NEW - 2025 UCare provider training series
Beginning Jan. 23, UCare will offer monthly, virtual training opportunities for participating providers, as well as separate training specifically designed for Elderly Waiver (EW) providers. The full schedule is now available.
Extension of three-month personal care assistance (PCA) service agreements
Effective immediately, members enrolled in UCare’s Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) who currently use PCA services will receive up to six months of PCA services while they transition to Community First Services and Supports (CFSS). UCare has automatically extended all current PCA three-month transition service authorizations.
Updated prior authorization criteria for drugs on the Individual and Family Plans formulary
On Feb. 1, 2025, UCare will update prior authorization criteria for drugs on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary.
2025 code and editing updates
New codes have been identified for 2025 and will be accepted into the UCare system. New codes will have published effective dates but are subject to the editing update and implementation dates. UCare uses multiple automated claims editing and pricing applications to ensure consistent and accurate processing of claims. Providers should allow time for the updates to be put into production to avoid resubmissions, adjustments or incorrect editing of the claims. Update and implementation dates vary.
Updates on claim payment for UCare Individual and Family Plans: Greater transparency in MinnesotaCare tax payments
UCare will begin reporting tax as its own adjustment on UCare Individual and Family Plans claims effective with Jan. 1, 2025, dates of service.
March 2025 Health Lines
Learn about the following: 2025 UCare Provider Manual released, UCare's provider training series, documentation compliance, Colorectal Cancer Awareness Month, Disease Management overview, weight management program: Cecilia Health weight management virtual support program, dental care on the move, connecting members to dental care, dental kits, fraud, waste and abuse reporting and more.
New Minnesota provider qualifications for Board-Certified Behavior Analysts (BCBA) requires licensing by state
Effective Jan. 1, 2025, Minnesota state law updated provider qualifications for BCBAs requiring them to be Licensed Behavioral Analysts (LBA). BCBAs are now required to be independently licensed and enrolled in Minnesota Health Care Programs (MHCP). As a result of the change, BCBA providers also must be credentialed with UCare to see UCare members.
2025 Q1 UCare Provider Manual Released
The Q1 UCare Provider Manual was updated to reflect current business practices.
Visit the UCare Provider Manual page for the most up-to-date version.
Durable Medical Equipment (DME) unlisted or enhanced items and supplies reimbursement to change
Effective April 1, 2025, providers who bill for unlisted or enhanced DME equipment and supply HCPCS codes submitted with a U3 modifier for UCare Minnesota Health Care Program (MHCP) members will receive new reimbursement rates.For details, see the Jan. 29 Provider Bulletin.
Medical Assistance (Medicaid) providers required to enroll with Minnesota Health Care Programs (MHCP) – Deadline extended for provider types requiring MHCP site visits
The 21st Century Cures Act requires states to enroll all Medical Assistance (Medicaid) providers. UCare providers who are contracted to provide services to Medical Assistance members are expected to enroll with MHCP, except for certain provider types that require a site visit from the Minnesota Department of Human Services (DHS) first. DHS has extended the enrollment requirement date to April 30, 2025, for these provider types. MHCP will conduct an announced site visit within 60 days of the referral date for the providers. These providers must complete both the enrollment process and site visit by April 30, 2025.
See the Jan. 28 Provider Bulletin for a list of provider types with an extension.
Tips and reminders regarding Nursing Facility Liability Letters
Learn more about when UCare is responsible for skilled nursing facility or nursing facility services and the Nursing Facility Liability Letter process.
See the Jan. 22 Provider Bulletin for details.
NEW - 2025 UCare provider training series
Beginning Jan. 23, UCare will offer monthly, virtual training opportunities for participating providers, as well as separate training specifically designed for Elderly Waiver (EW) providers. The full schedule is now available.
Extension of three-month personal care assistance (PCA) service agreements
Effective immediately, members enrolled in UCare’s Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) who currently use PCA services will receive up to six months of PCA services while they transition to Community First Services and Supports (CFSS). UCare has automatically extended all current PCA three-month transition service authorizations.
Updated prior authorization criteria for drugs on the Individual and Family Plans formulary
On Feb. 1, 2025, UCare will update prior authorization criteria for drugs on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary.
2025 code and editing updates
New codes have been identified for 2025 and will be accepted into the UCare system. New codes will have published effective dates but are subject to the editing update and implementation dates. UCare uses multiple automated claims editing and pricing applications to ensure consistent and accurate processing of claims. Providers should allow time for the updates to be put into production to avoid resubmissions, adjustments or incorrect editing of the claims. Update and implementation dates vary.
Updates on claim payment for UCare Individual and Family Plans: Greater transparency in MinnesotaCare tax payments
UCare will begin reporting tax as its own adjustment on UCare Individual and Family Plans claims effective with Jan. 1, 2025, dates of service.
Questions? Contact the Provider Assistance Center
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