Billing Sign and Oral Language Interpreter Services

PrimeWest Health covers sign and oral language interpreter services.

Bill PrimeWest Health using the following guidelines:

1. All enrolled providers except inpatient hospitals and special transportation providers* may bill PrimeWest Health for language interpreter services. If services are directly contracted through the interpreter, the provider is responsible for paying the interpreter. Use the same principles that you normally use when hiring, contracting, or arranging with a person to provide services to your patients.
2. The names of oral interpreters are required on all claims submitted to PrimeWest Health for reimbursement of face-to-face oral interpretation services. This is a change from the previous requirement, which stated only that names be noted in the medical record. Claims submitted without the interpreter name in the correct field or with the name of an interpreter that does not appear on the MDH Roster will be denied. The SV1 segment, element SV101-7 of the 5010 claim format, effective January 1, 2012, is designated for the inclusion of the interpreter name. Upon claim submission to PrimeWest Health, the interpreter listed on the claim will be validated against the MDH Roster.
3. Three people must be present for the service to be covered: the provider, the patient, and the interpreter.
   1. For sign language interpreter services, the interpreter may be on a video screen when using video remote interpreter services.
   2. For oral language interpreter services, the interpreter may be on the phone.
4. The patient’s friend or family member cannot act as the interpreter and receive reimbursement from PrimeWest Health.
5. Other staff members at the provider’s office who are qualified in sign language or competent in oral language interpretation may interpret the medical service. This interpreter service is billable.
6. Bill only for the direct face-to-face/video/phone service time. If the patient fails to show up for the appointment, then the interpreter service cannot be billed to PrimeWest Health.
7. When applicable, bill the patient’s Third Party Liability (TPL) insurance prior to billing PrimeWest Health.
8. Interpreter services performed must be billed on the 837P electronic claim format to allow billing the number of units.
9. Translating documents (paper to paper) is not a covered oral language interpreter service.

PrimeWest Health provides sign language services when such services are required for the member to receive or understand the health care services provided.

*Language interpreter services are part of the inpatient hospital Diagnosis Related Group (DRG) payment and cannot be billed separately during an inpatient stay. Special transportation providers cannot bill due to the nature of the service performed. The service of transporting a patient does not require interpreting.

Effective January 1, 2011, PrimeWest Health is implementing the Minnesota Administrative Uniformity Committee (AUC) recommendation to use modifiers when billing interpreter services.

When billing interpreter services for multiple recipients in a group setting, billing should include the appropriate modifier to indicate the number of patients served. This modifier should be submitted secondary to the type of interpretation provided (e.g., sign, telemedicine, etc.)

PrimeWest Health does not cover any of the following for the interpreter:

1. Travel time
2. Wait time
3. Mileage
4. No show/cancellations

Report one unit of T1013 per 15 minutes (at least eight minutes must be spent to report one unit). Use only the 837P or 837I formats to submit interpreter service claims. Bill only for the direct face-to-face/video/phone service time.

Interpreter services are not covered by Medicare but are covered under the member’s Medicaid benefit.

Additional Resources

eXchange: A resource for providers about language and cultural competency.

The eXchange, a Minnesota-based collaboration of health care related organizations, offers translated materials and resources for better health communication. Translated materials include vital documents (such as surgical consent forms) and health education materials (such as information about diabetes management, asthma, etc.).

MHCP-enrolled providers may download or print these translated materials form the eXchange and use them with patients with LEP. To access these materials, select the Translation Library link from the eXchange home page. When prompted, enter DHS (upper- or lowercase) as the login ID and as the password.

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Updated_04/02/2025