Provider Manual

Below is IMCare's provider manual.  This manual assists you and your staff to find important information such as general benefits, authorization requirements and claims billing information.

IMCare follows MN Department of Human Services (MNDHS) guidelines with a few exceptions. If there is a conflict between the Minnesota Health Care Programs (MHCP) Provider Manual and IMCare's Provider Manual, this manual and applicable federal and state statutes and regulations and/or federal/state contracts, applicable federal and state statutes and regulations and/or federal/state contracts will control.  IMCare reserves the right to supplement this manual to help ensure CMS and MNDHS terms and conditions remain in compliance with relevant federal and state statutes and regulations.  This manual will be amended as policies change.

IMCare may require prior authorization for certain services or items. For each healthcare service or item that requires a prior authorization, there are documented review criteria in place that have been developed or adopted by IMCare and reviewed by physicians from appropriate specialty areas.  All review criteria are available to the provider and member upon request free of charge.  Emergency services do not require prior authorization.

Provider Manual

  1. Acupuncture Chapter (PDF) Updated 10/24/23
  2. Adult Mental Health Targeted Case Management (PDF)
  3. Ambulatory Surgical Services (PDF) Updated 10/31/23
  4. Anesthesia Services (PDF) Updated 10/31/23
  5. Behavioral Health Home Services (PDF) Updated 10/31/23
  6. Billing Policy (PDF)
  7. Certified Community Behavioral Health Clinic (CCBHC) (PDF) Updated 11/10/23
  8. Children's Services (PDF)
  9. Chiropractic Services Chapter (PDF) Updated 10/24/23
  10. Clinic Services (PDF) Updated 11/17/2023
  11. Community Emergency Medical Technician (PDF)
  12. Community Health Worker (PDF)
  13. Community Paramedic Services (PDF) Updated 10/30/23
  14. COVID-19 (PDF) Updated 11/17/2023
  15. Dental Services (PDF)
  16. Early Intensive Developmental and Behavioral Intervention (PDF) Updated 11/09/2023
  17. Health Care Programs and Services (PDF)
  18. Hearing Aid Services (PDF) Updated 10/31/23
  19. Home and Community Based Services Elderly Waivers (PDF)
  20. Home Care Services (PDF) Updated 11/01/2023
  21. Hospice Services (PDF)
  22. Hospital Services (PDF) Updated 10/31/2023
  23. Housing Stabilization Services (PDF) Updated 10/30/23
  24. Immunizations and Vaccinations (PDF) Updated 11/17/23
  25. Lab Path Rad Diagnostic Services (PDF)
  26. Long-Term Care (PDF)
  27. Medication Therapy Management Services (MTMS) (PDF) Updated 10/31/23
  28. Mental Health Services (PDF) Updated 10/26/23
  29. Nursing Facility Services (PDF) Updated 11/01/23
  30. Optical Services (PDF) Updated 10/30/23
  31. Personal Care Assistance Services (PDF)
  32. Pharmacy Services (PDF)
  33. Physician and Professional Services (PDF) Updated 11/01/23
  34. Rehabilitation Services (PDF) Updated 11/01/23
  35. Relocation Service Coordination-Targeted Case Management (RSC-TCM) (PDF) Updated 10/30/23
  36. Reproductive Health - Obstetrics and Gynecology (PDF) Updated 11/17/23
  37. Requirements for Providers (PDF)
  38. Screening, Brief Intervention, and Referral for Treatment (SBIRT) (PDF) Updated 10/30/23
  39. Service Authorization (PDF)
  40. Substance Use Disorder Services SUD (PDF) Updated 10/30/23
  41. Supplies and Equipment (PDF)
  42. Telehealth Services (PDF) Updated 10/30/23
  43. Transportation Services (PDF)
  44. Tribal and Federal Indian Health Services (PDF) Updated 11/17/23