Mental Health Services

Minnesota’s publicly provided mental health system, as reflected in the Minnesota Comprehensive Mental Health Acts, is Minnesota Department of Human Services (DHS)-supervised and county-administered. Counties act as the local mental health authority. Review mental health provider requirements in Enrollment Requirements for information about criteria to be an eligible Minnesota Health Care Programs (MHCP) and PrimeWest Health mental health provider.

Mental Health Service Continuum

The service continuum for mental health is composed of the following six key components:

1. Diagnostic Assessment (DA)
2. Functional Assessment (FA)
3. Level of care utilization system (LOCUS)
4. Individual Treatment Plan (ITP)
5. Service delivery
6. Reassessment

Eligible Mental Health Providers

Mental health providers include agencies and individuals (professionals and practitioners). Each mental health agency must have at least one mental health professional on staff. Providers may be eligible to enroll as PrimeWest Health providers (mental health professionals) or may be eligible to provide services but not eligible to enroll as PrimeWest Health providers.

When qualified State staff provides adult mental health services, they are considered part of the certified local provider entity and their services may be billed in accordance with typical billing practices as appropriate to the specific service.

Enrollable Mental Health Agencies

1. Adult Day Treatment
2. Billing entity for mental health
3. County-contracted mental health rehabilitation service
4. Community Mental Health Center (CMHC)
5. County human service agency
6. Indian Health Service (IHS)
7. Outpatient hospital
8. Physician-directed clinic
9. School district

Enrollable Mental Health Professionals

1. Clinical Nurse Specialist (CNS)
2. Licensed Independent Clinical Social Worker (LICSW)
3. Licensed Marriage and Family Therapist (LMFT)
4. Licensed Professional Clinical Counselor (LPCC)
5. Licensed Psychologist (LP)
6. Mental health rehabilitative professional
7. Psychiatric nurse practitioner (NP)
8. Psychiatrist
9. Osteopathic physician
10. Tribal-certified professional

Who Can Conduct Mental Health Diagnostic Assessments (DAs) and Psychotherapy?

Select mental health practitioners may provide specific mental health services under limited conditions (MHCP Professional Certification & Enrollment Requirements).

Non-Enrollable Mental Health Providers

1. Adult mental health rehabilitation worker
2. Certified peer specialist (CPS)
3. Mental health behavioral aide (CTSS only)
4. Mental health practitioners
5. Mental health practitioner clinical trainee
6. Mental Health Targeted Case Manager/Case Manager Associate (CMA)

Clinical Supervision Requirements

Definition

Clinical supervision is the documented time a clinical supervisor and supervisee spend together to discuss the supervisee’s work, to review individual member cases, and for the supervisee’s professional development. It includes the documented oversight and supervision responsibility for planning, implementation, and evaluation of services for a member’s mental health treatment.

Coverage Requirements

All mental health practitioners must receive clinical supervision. Clinical supervision must be based on each supervisee’s written supervision plan and must do all of the following:

1. Promote professional knowledge, skills, and values development
2. Model ethical standards of practice
3. Promote cultural competency by:
   1. Developing the supervisee’s knowledge of cultural norms of behavior for individual members and generally for the members served by the supervisee regarding the member’s cultural influences, age, class, gender, sexual orientation, literacy, and mental or physical disability;
   2. Addressing how the supervisor’s and supervisee’s own cultures and privileges affect service delivery;
   3. Developing the supervisee’s ability to assess his/her own cultural competence and to identify when consultation or referral of the member to another provider is needed; and
   4. Emphasizing the supervisee’s commitment to maintaining cultural competence as an ongoing process.
4. Recognize that the member’s family has knowledge about the member and will continue to play a role in the member’s life and encourage participation among the member, member’s family, and providers as treatment is planned and implemented
5. Monitor, evaluate, and document the supervisee’s performance of assessment, treatment planning, and service delivery

Clinical supervision must be conducted by a qualified supervisor using individual and/or group supervision. Individual and/or group face-to-face supervision may be conducted via electronic communications that utilize interactive telecommunications equipment that includes, at a minimum, audio and video equipment for two-way, real-time, interactive communication between the supervisor and supervisee, and meet the equipment and connection standards of telemedicine.

1. Individual supervision means one or more designated clinical supervisors and one supervisee.
2. Group supervision means one clinical supervisor and two – six supervisees in face-to-face supervision.

Clinical supervision must be recorded in the supervisee’s supervision record. The documentation must include the following:

1. Date and duration of supervision
2. Identification of supervision type as individual or group supervision
3. Name of the clinical supervisor
4. Subsequent actions that the supervisee must take
5. Date and signature of the clinical supervisor

Clinical supervision pertinent to member treatment changes must be recorded by a case notation in the member record after supervision occurs.

Clinical Trainees

Medical Assistance (Medicaid) covers DA, explanation of findings, and psychotherapy performed by a mental health practitioner working as a clinical trainee when:

1. The mental health practitioner is:
   1. Complying with requirements for licensure or board certification as a mental health professional (does not include mental health rehabilitative professional), including supervised practice in the delivery of mental health services for the treatment of mental illness; or
   2. A student in a bona fide field placement or internship under a program (the individual is only considered a clinical trainee while at his/her internship/field placement, not at any other employment he/she may hold at that time) leading to completion of the requirements for licensure as a mental health professional; and
2. The mental health practitioner’s clinical supervision experience is helping the practitioner gain knowledge and skills necessary to practice effectively and independently. This may include supervision of the following:

1. Direct practice
2. Treatment team collaboration
3. Continued professional learning
4. Job management

Clinical Supervisor

A clinical supervisor must:

1. Be a licensed mental health professional;
2. Hold a license without restrictions that has been in good standing for at least one year while having performed at least 1,000 hours of clinical practice;
3. Be approved, certified, or in some other manner recognized as a qualified clinical supervisor by the person’s professional licensing board, when this is a board requirement;
4. Be competent as demonstrated by experience and graduate-level training in the area of practice and the activities being supervised;
5. Not be the supervisee’s blood or legal relative or cohabitant, or someone who has acted as the supervisee’s therapist within the past two years;
6. Have experience and skills that are informed by advanced training, years of experience, and mastery of a range of competencies that demonstrate the following:

1. Capacity to provide services that incorporate best practice;
2. Ability to recognize and evaluate competencies in supervisees;
3. Ability to review assessments and treatment plans for accuracy and appropriateness;
4. Ability to give clear direction to mental health staff related to alternative strategies when a recipient is struggling with moving towards recovery; and
5. Ability to coach, teach, and practice skills with supervisees;

7. Accept full professional liability for a supervisee’s direction of a member’s mental health services;
8. Instruct a supervisee in the supervisee’s work, and oversee the quality and outcome of the supervisee’s work with members;
9. Review, approve, and sign the DA, ITPs, and treatment plan reviews of members treated by a supervisee;
10. Review and approve the progress notes of members treated by the supervisee according to the supervisee's supervision plan (MN Rules 9505.0371);
11. Apply evidence-based practices and research-informed models to treat members;
12. Be employed by or under contract with the same agency as the supervisee;
13. Develop a clinical supervision plan for each supervisee;
14. Ensure that each supervisee receives the guidance and support needed to provide treatment services in areas where the supervisee practices;
15. Establish an evaluation process that identifies the performance and competence of each supervisee; and
16. Document clinical supervision of each supervisee and securely maintain the documentation record.

Clinical supervisors who supervise clinical trainees must complete the Qualified Mental Health Professional Clinical Supervision Assurance Statement (DHS-6330) in order for the clinical trainee’s time spent conducting DAs, psychotherapy, or explanation of findings to be billed.

Clinical Supervision Plan

The supervision plan must be developed by the supervisor and the supervisee. The plan must be reviewed and updated at least annually. For new staff, the plan must be completed and implemented within 30 days of the new staff person’s employment. The supervision plan must include the following:

1. The name and qualifications of the supervisee and the name of the agency in which the supervisee is being supervised
2. The name, licensure, and qualifications of the supervisor
3. The number of hours of individual and group supervision to be completed by the supervisee including whether supervision will be in person or by some other method approved by the commissioner
4. The policy and method that the supervisee must use to contact the clinical supervisor during service provision to a supervisee
5. Procedures that the supervisee must use to respond to member emergencies
6. Authorized scope of practices, including the following:

1. Description of the supervisee’s service responsibilities
2. Description of recipient population
3. Treatment methods and modalities

Eligible Members

All PrimeWest Health members are eligible. Refer to Benefits section for coverage determination.

A resident of an Institution for Mental Disease (IMD) is eligible to receive Medical Assistance (Medicaid) services only if the member is receiving inpatient psychiatric care in a Joint Commission of Accreditation of Healthcare Organizations (JCAHO)-accredited psychiatric facility and meets one of the following criteria:

1. Is under age 21
2. Is age 21 but less than age 22 and has been receiving inpatient psychiatric care in the IMD continuously since the resident’s twenty-first birthday
3. Is at least age 65

A Certificate of Need must be completed for members who are under age 21 at the time of admission to an IMD, per Title 42 Code of Federal Regulations (CFR) Part 441, Subpart D.

PrimeWest Health-Specific Mental Health Billing Guidelines – General

When units of time must be reported as part of the code definition, follow applicable Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) guidelines to determine the appropriate units of time to report. Per the guidelines, providers must spend more than half the time of a time-based code performing the service to report the code. If the time spent results in more than half the defined value of the code, and no additional time increment code exists, round up to the next whole number. Any other claim submission for services provided during the remaining balance of the unit of time is duplicative and ineligible. Review the following unit of measurement examples:

Right to Appeal Denial of Certification or County Contract

Providers required to be certified by or contracted with a county as part of the criteria to become an authorized provider of mental health services under Medicaid rules may Appeal to the commissioner a county refusal to grant the necessary contract or certification. A member may initiate an Appeal on behalf of a provider denied certification. A request for a review of the county decision may be sent/faxed to the Adult or Children’s Mental Health Division at:

DHS Mental Health Division – Appeal Review
PO Box 64981
444 Lafayette Rd
Saint Paul, MN 55164-0981

Or

For adults, fax to: 1-651-431-7418 (Attn: Mental Health Appeal Review)

For children, fax to: 1-651-431-2321 (Attn: Mental Health Appeal Review)

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Updated_10/24/2025