Community Health Worker Resources for Employers
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CHW Billing and Reimbursement
CHW Employer Toolkit
CHW Billing and Reimbursement
Overview of covered CHW Services in Minnesota
Since 2009, Minnesota's Medicaid program, known as Minnesota Health Care Programs (MHCP), including Medical Assistance and MinnesotaCare, has covered “diagnosis–related health education” as specified by the CHW´s authorized ordering provider. Many provider types may supervise CHWs, including physicians, dentists, public health nurses and mental health professionals among others.
As of 2024, MHCP also covers Community Health Integration (CHI) services defined by Medicare and performed by CHWs. CHI services are services that address unmet Health Related Social Need needs that affect the diagnosis and treatment of the patient including assessment and planning, system navigation, facilitating access to resources, care coordination, health education, self-advocacy, social and emotional support, and health coaching or motivation to reach care plan goals.
The Minnesota Department of Human Services Provider Manual provides the most up-to-date information on enrollment and reimbursement for CHWs. For questions regarding the manual, contact the Minnesota Health Care Programs Provider Resource Center.
Questions regarding coverage, payment and reimbursement for clients enrolled in a non-MHCP managed care organization or commercial insurance carrier should be directed to those specific organizations.
CHW Billing Toolkit
Overview
The CHW Billing Toolkit was developed in 2025 in response to barriers identified by CHWs and CHW services organizations in understanding and implementing billing for CHW services in Minnesota. These barriers are laid out in the 2024 CHW Initiatives in Minnesota: An Environmental Scan of the CHW Field (PDF) and the 2025 Sustainable CHW Roadmap for Minnesota.
The toolkit is for Minnesota CHW/CHR service organizations, Minnesota health care providers interested in linking patients with reimbursable CHW/CHR services, and individual CHWs/CHRs interested in understanding how CHW training enables medical billing and reimbursement for services.
Toolkit
Workflows and checklists
The toolkit’s workflows and checklists are grouped by organization type. Each organization type has two workflows with related checklists. There is one workflow and one checklist for health education services, and one workflow and one checklist for Community Health Integration (CHI) services.
- Health Care Organizations (HCO)
- Community Based Organizations (CBO)
- Hub Organizations
Toolkit appendices
Questions?
For questions about the toolkit or for assistance in using the tools in the toolkit contact us: health.chw.mdh@state.mn.us.
The information provided in this toolkit is for general informational and educational purposes only and does not constitute legal, billing, or compliance advice. Organizations are responsible for ensuring that all billing practices comply with applicable federal and state laws, including CMS and Minnesota Department of Human Services (DHS) regulations, MHCP provider guidelines, and organizational policies and procedures. Information on CHW billing was compiled based on emerging guidance related to Medicare and MHCP billing and reimbursement at the time the toolkit was developed. Users should consult CMS, MN DHS, and their organizational billing or compliance departments for the most current and authoritative information before submitting any claims.
The MDH Employer Toolkit was developed in 2016 in partnership between the Minnesota Department of Health, the Minnesota Community Health Worker Alliance, and WellShare International.
The toolkit provides employers and prospective employers with practical guidance for organizational and practice integration of CHWs and understanding the education and competencies of CHWs.
An update to the toolkit is currently under development and will be posted here once complete.