MHCP Provider News and Updates

Pended authorization request response time changed :

Providers will have 15 calendar days to respond to pended authorization requests beginning Dec. 1, 2019. We will deny the request if you do not respond after 15 days and you will need to submit a new request. This change was made because KEPRO’s accreditor requires a faster turnaround time. (pub. 10/29/19)

Minnesota Health Care Programs (MHCP) fee-for-service (FFS) payments for HCPCS G0101 or Q0091 no longer allowed effective Jan. 1, 2020 :

MHCP FFS will no longer allow payment for HCPCS G0101 (Cervical or vaginal cancer screening) or Q0091 (Screening Pap smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory) beginning Jan. 1, 2020.

Obtaining a screening pap smear is part of a comprehensive preventive service and should not be reported separately. The collection of a diagnostic pap smear due to symptoms or illness is included in the physical exam portion of a problem-oriented Evaluation and Management service and is not separately reportable.

Continue using the appropriate CPT codes for pap smears for the pathologist’s interpretation of the cytology specimen. (pub. 10/7/19, rev. 10/14/19)

Source: https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/minnesota-health-care-programs/provider-news/