The only procedure codes that can be submitted are: 97153, 97154, 97155, 97156, 97157, H0032, AND H0046 with modifier UB.

 NOTE: You must attach the Individual Treatment Plan (ITP) Form with the Signature Page. This Form selection is available in the drop down when you are attaching your document(s).

GENTLE REMINDER – PLEASE CHECK RECIPIENT ELIGIBILITY PRIOR TO SUBMISSION TO PREVENT DELAY IN SERVICES. KEPRO IS THE MEDICAL REVIEW AGENT FOR MN MA ONLY