Home Health Agency (HHA)- Adding or Changing Service Area

A Medicare-certified home health agency that wants to add or change a service area will provide written notification of the following:

• Name and address of the agency
• Health Facility Identification Number (HFID)
• CMS Certification Number (CCN)
• Counties in current service area
• Counties you wish to add
• Notice will be signed by HHA official

Email above documents to : Health.HRD-FedLCR@state.mn.us

Submit the CMS 855A to the Medicare Administrative Contractor (MAC) for the change of the service area.

• CMS 855A Medicare Enrollment Application (PDF)
• Medicare Fee-for-Service Provider Enrollment Contact List

MDH makes the final decision and will send you a letter either approving or denying your proposed service area.

The State Operations Manual - Chapter 2 - Organization of HHA - Chapter 2182 (PDF) provides detailed information about Geographic Service Area

Any questions, please email:  Health.HRD-FedLCR@state.mn.us