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Community Paramedic Services

Revised: 10-09-2018


In 2011, the Minnesota legislature enacted into law the new profession of Community Paramedic to meet the health care needs of recipients living in underserved communities.

Eligible Providers

Community Paramedics (CP)( who:

  • • Are certified by the Minnesota Emergency Medical Services Regulatory Board (EMSRB)
  • • Are employed by an MHCP-enrolled ambulance service
  • • Have a service scope agreement, based on the paramedic’s skills, with the Medical Director of the ambulance service
  • To obtain a community paramedic certificate from the EMSRB an applicant must have:

  • • A current paramedic certification of EMT-P
  • • Two years of full-time services as an EMT-P
  • • Graduated from an accredited course
  • Eligible Recipients

    MHCP members enrolled in the following MHCP programs are eligible for community paramedic services:


    MinnesotaCare Plus One


    MinnesotaCare Basic Plus


    MinnesotaCare Basic Plus Two
    MinnesotaCare Expanded


    Medical Assistance


    State-funded Medical Assistance




    MinnesotaCare Basic Plus

    Members enrolled in the following programs are not eligible for MHCP community paramedic services:


    Alternative Care Program


    Emergency Medical Assistance


    Minnesota Family Planning Program




    Institution for Mental Disease


    Qualified Medicare Beneficiary

    Community paramedics assist in the care of members who:

  • • Receive hospital emergency department services three or more times in four consecutive months within a twelve month period
  • Or
  • • Are identified by or require one or more of the following:
  • • Are identified by their primary care provider at risk of nursing home placement
  • • May require set up of services for discharge from a nursing home or hospital
  • • May require services to prevent readmission to a nursing home or hospital
  • Covered Services

    Services must be part of the care plan ordered by the member’s primary care provider (physician, advanced practice registered nurse (APRN) or physician’s assistant). The primary care provider consults with the ambulance service’s medical director to ensure there is no duplication of services.

    Either the primary care provider or the medical director must coordinate the care plan with all local community health providers and the local public health agencies, including home health and waiver services, to avoid duplication of services to the member. Services the community paramedic may perform are:

  • • Health assessments
  • • Chronic disease monitoring and education
  • • Medication compliance
  • • Immunization and vaccinations
  • • Laboratory specimen collection
  • • Hospital discharge follow-up care
  • • Minor medical procedures approved by the ambulance medical director
  • Noncovered Services

    The following services are not covered:

  • • Travel time
  • • Mileage
  • • Facility fee
  • • Services related to hospital-acquired conditions or treatments
  • Documentation Requirements

    Keep complete documentation on file. Refer to the Provider Requirements section for guidelines.


    Refer to Billing Policy for general MHCP billing policies. The MHCP-enrolled medical director of the ambulance service employing the community paramedic must bill the community paramedic services:

  • • Bill using the 837P
  • • In the “Treating Provider” field, enter the medical director’s NPI
  • • Enter the clinic, hospital or ambulance service’s NPI/UMPI in the “Pay To” field
  • • Use code T1016 with modifier U3
  • • Place of service is 12 (home)
  • • Bill in 15 minute increments (one unit = 15 minutes)
  • More than half the time (eight minutes), must be spent performing the service face-to-face in order to report a unit.

    Bill supplies primary to the encounter separately. Supplies used by the community paramedic in direct relationship to the illness or injury are considered incidental to the service and not separately billable to MHCP.

    Legal References

    Minnesota Statutes 256B.0625, subd. 60 (Community Paramedic Services)
    Minnesota Statutes 144E.28, subd.9
    (Certification of Community Paramedics)
    Minnesota Statutes 144E.01, subd.5f
    (Emergency Medical Services Regulatory Board)

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