Updated Hennepin Health 2023 prior authorization requirements

• 8/31/2023
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September 1, 2023

Subject

Changes to Hennepin Health prior authorization list starting Sept. 1, 2023.

Providers affected

All

Key points

• Hennepin Health implemented changes to the prior authorization list beginning September 1, 2023. 
• These changes include clarifying Early Intensive Developmental and Behavioral Intervention (EIDBI) prior authorization requirements, and removing the 54-visit authorization limit for skilled nurse visits for Special Needs BasicCare (SNBC) members.
  
   

Background

As of September 1, 2023, the below changes were made to Hennepin Health’s prior authorization list.

• EIDBI – Hennepin Health added codes and descriptions for specific interventions that require authorization. The EIDBI CPT/HCPC codes requiring authorization include:

- Intervention – Individual: Adaptive behavior (97153UB)
- Intervention – Group: Adaptive behavior (97154UB)
- Intervention – Higher intensity: Adaptive behavior (0373T)
- Intervention – Individual: Observation and direction (97155UB)
- Family or caregiver training and counseling – Individual (97156UB)
- Family or caregiver training and counseling – Group (97157UB)
- Travel time (H0046UB)

• Skilled nurse visits – Hennepin Health removed the 54-visit authorization limit for skilled nurse visits for SNBC members. All skilled nurse visits for SNBC members now require authorization.  

Resources

• Hennepin Health Customer Service: 612-596-1036 (press 2)
• Hennepin Health website 
• Hennepin Health Prior authorization webpage