Medicare Demonstration/Payment



Medicare Payment for Health Care Home Services

Background

Minnesota was selected by the Centers for Medicare and Medicaid Services (CMS) to be one of eight states participating in the Medicare Multi-payer Advanced Primary Care Practice (MAPCP) demonstration Project.  The demonstration added Medicare to Minnesota’s existing multi-payer health care home initiative as a payer for certified health care homes.

The Minnesota Departments of Health and Human Services jointly applied for the demonstration project, with guidance from a wide array of stakeholders. The demonstration began in 2011 and has now been extended until 12/31/2014. The current payment rates will remain in effect.

Through Minnesota's participation in the Medicare Multi-payer Advanced Primary Care Practice (MAPCP) demonstration, certified health care homes  have been  reimbursed for care coordination services provided to fee-for-service Medicare beneficiaries  since 10/1/11.

Health care home payment rates for Medicare have been approved by the federal Office of Management and Budget (OMB) [PDF: 284KB/2 pages]

Certified Health Care Homes who wish to participate in the MAPCP demonstration and have not already notified MDH should contact MDH at health.healthcarehomes@state.mn.us or call 651-201-5421.

What does Extending the Demo Mean?

Extending the MAPCP Demo means that;

  • Clinics can continue to submit Medicare claims for FFS Medicare patients through 12/31/2014 through the Demo.

  • Clinics can still BEGIN submitting claims to the demo. 

  • You may submit care coordination claims retroactively for one year or to the date of your certification for FFS until 12/31/2014.  (See Medicare Rules).

  • Clinics must submit your Medicare Provider numbers for certified providers to MDH in ADVANCE of submitting claims and they must include the demo “58” code on each claim.
  • More information on:

    Requirements Overview
    Denials
    Quick Facts
    MAPCP Quarterly Reports
    MAPCP Billing Instructions and Webinars
    MAPCP Steering Committee

    Updated Wednesday, 09-Apr-2014 11:25:37 CDT