Home Health Agencies (HHA)- Services Across State Lines

Provide written a notice on letterhead and include the following:

• Health Facility Identification Number (HFID)
• CMS Certification Number (CCN)
• Proposed state and counties
• Letter signed by HHA official

Complete the expansion of service area procedure which is posted on the Minnesota Department of Health (MDH) website.  See link below:

• https://www.health.state.mn.us/facilities/regulation/hhamedicare/servicearea.html

If deemed status, MDH will not process the request to provide services across state lines until after we have received a copy of the approval letter from the accrediting organization.

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

Submit CMS 855A application and all supporting documentation should be submitted to the designated Medicare Administrative Contractor (MAC)

• CMS 855A Medicare Enrollment Application (PDF)

See link below for MAC contacts

• (See Medicare Fee-for-Service Provider Enrollment Contact List

The State Operations Manual - Chapter 2 - Organization of HHA - Chapter 2184 (PDF) provides detailed information about Operation of HHAs Across State Lines 

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