MHCP Pays Reference and Outside Laboratory Providers Directly

Effective for dates of service on and after Jan. 1, 2015, Minnesota Health Care Programs (MHCP) fee-for-service (FFS) will reimburse a provider for a service only if the provider personally performed the service. This means that MHCP no longer will pay a provider for laboratory services that the provider sent to a reference or outside laboratory. If you or your organization sends laboratory services to a reference or outside laboratory provider, the laboratory that performs the service must bill MHCP directly. For services billed by Independent laboratories (when the service was referred to another independent or hospital laboratory), this policy change applies effective with dates of service on or after July 1, 2015.