TBS vs PSR in Ohio: what differs, who can bill, and the codes
TBS vs PSR in Ohio: OAC 5160-27-08 definitions, who can render H2019 and H2017, group TBS (H2019 HQ), the shared 200-unit threshold, and the 2026 proposal.
Updated September 23, 2026
Blog
Guides for Minnesota care agencies.
Documentation rules, billing codes, EVV thresholds, licensing steps, and audit preparation for ARMHS, 245D, PCA/CFSS, EIDBI, and adult day services, written from inside Minnesota agencies and checked against DHS sources.
Latest guides
Ohio CPST changes in 2026: ODM's proposal to remove CPST
Ohio CPST changes in 2026 are still a proposal: ODM floated removing CPST from rule 5160-27-02 and giving TBS and PSR a 200-unit threshold each.
Updated September 23, 2026
Ohio Medicaid behavioral health prior authorization: 2026 thresholds
Ohio Medicaid behavioral health prior authorization since July 1, 2026: TBS, PSR, CPST, and SUD thresholds, pass-through rules, ODM forms, and 90-day minimum.
Updated September 23, 2026
ARMHS
Adult Rehabilitative Mental Health Services in Minnesota: documentation under Chapter 245I and §256B.0623, functional assessments, treatment plans, progress notes, supervision, and H2017 billing.
ARMHS changes in 2027: hour limits, prior authorization, 245I licensure
ARMHS changes in 2027 and 2028 under Laws 2026 ch. 121: 4 hours per week, 18 hours per month, prior authorization above 200 hours, and 245I licensure.
Updated September 13, 2026
ARMHS eligibility in Minnesota: who qualifies and how to document it
ARMHS eligibility under § 256B.0623, subd. 3: age, Medical Assistance, diagnosis, three impaired areas, LOCUS, the proof behind each, and when to re-determine.
Updated September 12, 2026
What is ARMHS? Adult Rehabilitative Mental Health Services explained
What is ARMHS? A plain-language guide to Minnesota's Adult Rehabilitative Mental Health Services: eligibility, services, staff, billing, and 2027 changes.
Updated September 12, 2026
ARMHS staff qualifications: professional, practitioner, MHRW, peer
ARMHS staff qualifications under § 256B.0623, subd. 5 and § 245I.04: professional, practitioner, trainee, MHRW, peer specialist, and the 30-hour MHRW training.
Updated September 11, 2026
ARMHS clinical supervision requirements: frequency, observation, log
ARMHS clinical supervision (treatment supervision under § 245I.06): the written plan, monthly meetings, MHRW direct observation, co-signatures, and the log.
Updated September 11, 2026
ARMHS billing in Minnesota: H2017, units, modifiers, and clean claims
ARMHS billing in Minnesota: H2017 15-minute units, HM, HQ, and U3 modifiers, MN-ITS 837P claims, remittance advice, common denials, and pre-claim checks.
Updated September 9, 2026
ARMHS functional assessment and treatment plan: timelines and mistakes
ARMHS functional assessment rules under § 245I.10: ten domains, natural support input, LOCUS, treatment plan contents, ten-day approval, and 180-day reviews.
Updated September 4, 2026
How to write an ARMHS progress note that passes a DHS audit
How to write an ARMHS progress note in Minnesota: every § 245I.08 element, a worked example, MHRW co-signatures, telehealth notes, and a template checklist.
Updated September 2, 2026
ARMHS documentation requirements in Minnesota: the 245I checklist
ARMHS documentation requirements in Minnesota: the 245I client record, functional assessment, ITP, progress note elements, co-signatures, and DHS timelines.
Updated September 15, 2026
245D waivered services
Minnesota 245D home and community-based services: licensing, support plans, progress reviews, incident reporting, staff training, and DHS licensing reviews.
The most common 245D licensing citations and how to avoid them
245D licensing citations: the record, training, incident, medication, and rights findings DHS licensors cite, the statute behind each, and how to fix them.
Updated September 11, 2026
245D basic vs intensive support services: the obligations that differ
245D basic vs intensive support services compared: the § 245D.03 lists, § 245D.07 vs § 245D.071 planning timelines, training, restraint rules, and records.
Updated September 10, 2026
What is 245D? Minnesota's home and community-based services standards
What is 245D? An explanation of Minnesota's HCBS Standards: who needs the license, basic vs intensive services, license holder duties, and DHS enforcement.
Updated September 10, 2026
245D medication administration and setup requirements (245D.05)
245D medication administration under § 245D.05: setup vs assistance vs administration, MAR contents, written authorization, errors, training, and § 245D.051.
Updated September 9, 2026
245D training requirements: orientation and annual topics (245D.09)
245D training requirements under Minn. Stat. § 245D.09: orientation within 60 days, the 72-hour maltreatment rule, annual topics, and the training record.
Updated September 5, 2026
245D person-centered planning: the CSSP, the addendum, and outcomes
245D person-centered planning under § 245D.07 and § 245D.071: the CSSP vs the provider's addendum, 15-day and 60-day steps, measurable outcomes, and reviews.
Updated September 9, 2026
245D incident reporting: what to report and the timelines
245D incident reporting in Minnesota: § 245D.06 incident definitions, the 24-hour report, emergency manual restraint timelines, MAARC, and DHS notices.
Updated September 5, 2026
245D documentation checklist: support plans, reviews, and records
245D documentation checklist for Minnesota HCBS providers: the service recipient record, support plan addendum timelines, progress reviews, and retention.
Updated September 3, 2026
245D license in Minnesota: who needs one and how to apply
245D license guide for Minnesota HCBS providers: which waiver services need one, basic vs intensive support, application steps, fees, and the 2026-2027 pause.
Updated September 3, 2026
PCA / CFSS
Personal care assistance and Community First Services and Supports: the transition deadline, agency requirements, worker training, care plans, and billing.
CFSS support worker requirements: training, background studies, competency
CFSS support worker requirements in Minnesota under § 256B.85: background study, DHS training and test, enrollment, and 30-day and 90-day competency checks.
Updated September 12, 2026
CFSS agency model vs budget model: a side-by-side comparison
CFSS agency model vs budget model in Minnesota: who employs the worker, payroll, supervision, FMS, purchases, training, SEIU coverage, EVV, and how to switch.
Updated September 8, 2026
PCA timesheet requirements and CFSS visit documentation in Minnesota
PCA timesheet requirements under § 256B.0659, subd. 12 and CFSS time sheets under § 256B.85, subd. 15: fields, signatures, EVV, five-year retention, audits.
Updated September 12, 2026
What is CFSS? Community First Services and Supports explained
What is CFSS? Community First Services and Supports is the Minnesota Medicaid program replacing PCA and CSG by Sept 30, 2027: models, eligibility, services.
Updated September 8, 2026
The CFSS service delivery plan: what it must contain and who signs it
The CFSS service delivery plan under Minn. Stat. § 256B.85, subd. 6: the 15 required contents, who develops and signs it, lead agency approval, and updates.
Updated September 12, 2026
CFSS billing for Minnesota agency providers: codes, units, authorizations
CFSS billing guide for Minnesota agency providers: T1019 units, T1023, S5116, service authorizations, EVV as a precondition, MN-ITS 837P, and common denials.
Updated September 8, 2026
PCA to CFSS transition: what Minnesota agencies must do by Sept 30, 2027
PCA to CFSS transition guide for Minnesota agencies: the September 30, 2027 deadline, DHS-8160A and DHS-8560, competency visits, and how participants move.
Updated September 8, 2026
Electronic visit verification
Minnesota EVV rules for home care agencies: HHAeXchange enrollment, the 50% and 80% compliance thresholds, what makes a visit compliant, and how to fix the gaps.
EVV reason codes: visit edits and manual entries without losing compliance
EVV reason codes in Minnesota: what makes a visit noncompliant, the DHS edit and missed-visit code lists, who may edit, and how edits count toward 80%.
Updated September 11, 2026
EVV compliance checklist: how Minnesota agencies reach 80% and stay there
EVV compliance checklist for Minnesota home care agencies: measure your rate, fix the causes of manual visits, set edit policies, and answer a DHS notice.
Updated September 1, 2026
HHAeXchange in Minnesota: enrollment, aggregator, third-party EVV
HHAeXchange Minnesota guide: mandatory enrollment since January 1, 2026, the free state system vs the aggregator path for third-party EVV, data flows, and MCOs.
Updated September 6, 2026
Minnesota EVV requirements in 2026: thresholds, HHAeXchange, and deadlines
Minnesota EVV requirements in 2026: the 50% and 80% compliance thresholds, mandatory HHAeXchange enrollment, covered services, and the DHS enforcement timeline.
Updated September 1, 2026
EIDBI
Early Intensive Developmental and Behavioral Intervention: provider requirements under §256B.0949, CMDE, treatment plans, supervision, and CPT billing.
The EIDBI CMDE: who performs it, what it contains, when it is updated
The EIDBI CMDE in Minnesota: § 256B.0949 subd. 5 content, who can perform it, 97151 billing with UB, how it feeds the ITP and authorization, and update timing.
Updated September 13, 2026
EIDBI family training (97156): rules, documentation, and billing
EIDBI family training under § 256B.0949: 97156 vs 97157, who may provide it, UB modifier and units, telehealth, the ITP, session notes, and denials.
Updated September 13, 2026
EIDBI QSP requirements: qualifications and the 2026 employee rule
EIDBI QSP requirements in Minnesota: § 256B.0949 subd. 15 licenses and 2,000 hours, QSP duties, supervision minimums, the 2026 employee rule, and DHS-7120C.
Updated September 9, 2026
What is EIDBI? Minnesota's autism intervention benefit explained
What is EIDBI? Minnesota's Medical Assistance autism benefit for people under 21: who qualifies, the CMDE, modalities, provider roles, and the 2026 rules.
Updated September 9, 2026
EIDBI documentation: ITP, session notes, and progress monitoring
EIDBI documentation in Minnesota: CMDE content, the ITP under § 256B.0949, session notes, data collection, six-month progress monitoring, and audits.
Updated September 6, 2026
EIDBI billing codes in Minnesota: 97151 to 97157, 0373T, and the 97155 rule
EIDBI billing codes in Minnesota: 97151 to 97157 and 0373T, 15-minute units, the UB modifier, the 20% rule for 97155, authorizations, and denials.
Updated September 4, 2026
EIDBI provider requirements in Minnesota: QSP, levels, CMDE, moratorium
EIDBI provider requirements in Minnesota: § 256B.0949 eligibility, CMDE, QSP and Level I to III qualifications, the 2026 QSP employee rule, and the moratorium.
Updated September 4, 2026
Adult day services
Adult day services and adult day care in Minnesota: 245A licensing, Rule 9555, attendance records, transportation, and waiver billing.
Adult day services medication and health services under Rule 9555
Adult day services medication and health services under Minn. R. 9555.9710: monthly RN review, medication assistance policies, records, incidents, audits.
Updated September 14, 2026
Adult day services plan of care: Rule 9555's 30-day and 90-day rules
The adult day services plan of care under Minn. R. 9555.9700: intake screening, the 30-day preliminary plan, the 90-day plan, quarterly review, and billing.
Updated September 13, 2026
Adult day services staffing ratios and training under Rule 9555
Adult day services staffing ratios in Minnesota: the 1:8 and 1:5 rule in Minn. R. 9555.9690, the mixed-group formula, who counts as staff, and training hours.
Updated September 10, 2026
What are adult day services in Minnesota? Eligibility and funding
Adult day services in Minnesota explained: the 245A and Rule 9555 definition, center vs family adult day, who attends, waiver funding, and the 2026 pause.
Updated September 10, 2026
Adult day services billing in Minnesota: S5102, T2003, attendance records
Adult day services billing in Minnesota: S5102 vs S5100, T2003 UC transportation, DWRS and Elderly Waiver rates, attendance records, and denials.
Updated September 6, 2026
Adult day services license in Minnesota: 245A, Rule 9555, and the pause
The adult day services license Minnesota centers need: ch. 245A, Rule 9555 staffing and space rules, licensing, the 2026 to 2028 pause, and waiver enrollment.
Updated September 3, 2026
Compliance & audits
DHS audits, program integrity, Minnesota Revalidate, provider enrollment, HIPAA, and how Minnesota agencies stay audit-ready every day.
How to start a home care agency in Minnesota (2026 rules)
How to start a home care agency in Minnesota under 2026 rules: frozen service lines, the MDH home care license, MHCP enrollment, background studies, and EVV.
Updated September 11, 2026
HIPAA compliance for Minnesota home care agencies: the checklist
HIPAA compliance home care guide for Minnesota agencies: covered entity status, the BAA, safeguards, audit logs, six-year retention, and consent rules.
Updated September 2, 2026
Vulnerable adult maltreatment reporting in Minnesota: MAARC, timelines
Vulnerable adult maltreatment reporting in Minnesota: mandated reporters, the 24-hour rule in § 626.557, MAARC phone and online reporting, and 245A.65 policies.
Updated September 8, 2026
Minnesota DHS background study and NETStudy 2.0: who needs one and when
Minnesota background study rules under Minn. Stat. ch. 245C: who is studied in 245D, PCA/CFSS, EIDBI, and adult day, timing, NETStudy 2.0, fees, and set-asides.
Updated September 8, 2026
Minnesota Revalidate 2026 and the enrollment freeze: what providers must do
Minnesota Revalidate 2026 explained: the CMS plan, the May 31 deadline, fingerprint studies, site visits, the 13-service enrollment freeze, and 2027 dates.
Updated September 11, 2026
Minnesota DHS audit preparation checklist for care agencies
Minnesota DHS audit checklist for care agencies: review types, what auditors request, records timelines, sampling, findings letters, and OAH appeals.
Updated September 7, 2026
Software & alternatives
Choosing Minnesota agency software: buyer's checklists for ARMHS, PCA/CFSS and 245D, and factual comparisons with Caretap, Billiyo, Alora and Procentive.
Best home care software in Minnesota (2026): a program-by-program guide
The best home care software in Minnesota depends on the program you bill. Nine systems compared on HHAeXchange EVV, 245D, CFSS, ARMHS and MHCP billing rules.
Updated September 16, 2026
Alora home care software alternatives for Minnesota agencies
Alora home care software alternative guide for Minnesota agencies: attributed facts about Alora Health, a comparison framework, and a migration checklist.
Updated September 16, 2026
Billiyo alternatives for Minnesota agencies: what to compare
Billiyo alternative guide for Minnesota PCA, CFSS, and home health agencies: attributed facts, a neutral comparison framework, and a migration checklist.
Updated September 15, 2026
Caretap alternatives for Minnesota agencies: what to compare
Caretap alternative guide for Minnesota agencies: what Caretap says it does, a neutral comparison framework, pricing models, and a migration checklist.
Updated September 15, 2026
Procentive alternatives for Minnesota agencies: what to compare
Procentive alternative guide for Minnesota ARMHS, 245D, PCA/CFSS, and EIDBI agencies: a fair comparison framework, pricing models, and a migration checklist.
Updated September 14, 2026
How to choose PCA agency software in Minnesota: a CFSS checklist
How to choose PCA agency software for Minnesota CFSS providers: HHAeXchange EVV integration, caregiver app, authorizations, claims, credentials, pricing.
Updated September 23, 2026
How to choose ARMHS software in Minnesota: a buyer's checklist
How to choose ARMHS software in Minnesota: what it must enforce under 245I, vendor questions, pricing models, migration, HIPAA security, and red flags.
Updated September 23, 2026
Billing & claims
MHCP billing for Minnesota agencies: MN-ITS, 837P claims, remittance advice, denials, appeals, and choosing software that keeps claims clean.
Appeal MHCP claim denials in Minnesota: deadlines, packets, escalation
How to appeal MHCP claim denials in Minnesota: replace or dispute, fee-for-service reconsideration, MCO appeals within 60 days, the packet, and escalation.
Updated September 10, 2026
MHCP claim denials: common reasons and how to fix them
MHCP claim denials in Minnesota: how to read the 835, the most common denial codes, timely filing, replacement claims, MCO appeals, and prevention.
Updated September 15, 2026
Service agreements and MHCP prior authorization: how they drive claims
MHCP prior authorization vs waiver service agreements: DHS-4695, Acentra Health review timelines, how authorized units reach the claim, and when they run out.
Updated September 9, 2026
MHCP overpayments: recoupment, offsets, and self-disclosure in Minnesota
MHCP overpayment rules in Minnesota: how DHS finds them, § 256B.064 recovery and offsets, interest, the 60-day return rule, self-reporting, and appeals.
Updated September 10, 2026
MHCP timely filing: the 12-month rule, replacement claims, and voids
MHCP timely filing in Minnesota: the 12-month rule, the replacement claim window, the Minn. R. 9505.0450 exceptions, voids, and how to prove timely submission.
Updated September 9, 2026
Minnesota managed care organizations billing: MSHO, MSC+, county plans
Minnesota managed care organizations billing: PMAP, MinnesotaCare, MSHO, MSC+, SNBC, the 2026 health plans, fee-for-service carve-outs, and a payer matrix.
Updated September 7, 2026
The 837P claim for Minnesota HCBS agencies: the fields that get denied
837P claim guide for Minnesota HCBS agencies: NPI or UMPI identifiers, the CLM segment, service lines, modifiers, units, REF*G1, and 999/277CA rejections.
Updated September 5, 2026
MHCP eligibility verification: MN-ITS 271, managed care, spenddowns
MHCP eligibility verification in Minnesota: the MN-ITS 270/271 request, what the 271 shows, managed care, spenddowns, retroactive MA, and order of payment.
Updated September 7, 2026
MN-ITS for Minnesota providers: mailbox, claims, remittances, and the 835
MN-ITS for Minnesota providers: the mailbox and PRVLTR folder, 270/271 eligibility, DDE and batch 837P claims, 276/277 status, the 835, and user admin.
Updated September 5, 2026
Ohio behavioral health
Ohio Medicaid community behavioral health for agencies: TBS, PSR and CPST rules under OAC Chapter 5160-27, the July 2026 prior authorization thresholds, and the proposed 2026 rule changes.
TBS vs PSR in Ohio: what differs, who can bill, and the codes
TBS vs PSR in Ohio: OAC 5160-27-08 definitions, who can render H2019 and H2017, group TBS (H2019 HQ), the shared 200-unit threshold, and the 2026 proposal.
Updated September 23, 2026
Ohio CPST changes in 2026: ODM's proposal to remove CPST
Ohio CPST changes in 2026 are still a proposal: ODM floated removing CPST from rule 5160-27-02 and giving TBS and PSR a 200-unit threshold each.
Updated September 23, 2026
Ohio Medicaid behavioral health prior authorization: 2026 thresholds
Ohio Medicaid behavioral health prior authorization since July 1, 2026: TBS, PSR, CPST, and SUD thresholds, pass-through rules, ODM forms, and 90-day minimum.
Updated September 23, 2026