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Emergency Medical Assistance

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Announcements | Training and Reference Material | FAQs

At a Glance

Emergency Medical Assistance

Emergency Medical Assistance services support providers in delivering emergency care for eligible individuals who meet EMA criteria. Providers must follow MHCP guidelines for documentation, authorization, and billing through MN–ITS to ensure compliance and timely reimbursement.

Training & Reference Materials

Submitting Requests and Forms

CPC Requests and Recertifications

Include the EMA CPC Request form with all requests if you do not have an approval letter.   Acentra will not accept a Prime Therapeutics Drug Authorization form alone.

 EMA Drug Requests

Two options to submit:

(1) Submit the EMA CPC Approval letter along with the Prime Drug form.

(2) Submit the DHS CPC Form and choose the option indicating a Drug Auth request, the Prime Drug Auth request form is not required

 

DHS- 3642 EMA - Care Plan Certification Request Form

Prime Therapeutics Drug Prior Authorization Request Form

EMA Provider Portal Training
  • EMA Provider Portal Training PPT
MHCP Provider Manual Page

Emergency Medical Assistance

Frequently Asked Questions

EMA FAQ's Coming Soon

Contact Us
MN SUD:MinnesotaASAM@acentra.com
Dental:DentalMNMedicaid@acentra.com
MN EMA: EMAMNMedicaid@acentra.com
MNproviderissues@acentra.com
P: (866) 433-3658
F: (866) 889-6512

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10th Floor
McLean, VA 22102

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