Enhanced Asthma Care Services Available to Eligible Patients


A new law enacted during the 2021 legislative session and effective earlier this year expands medical assistance to cover “enhanced asthma care services.” Services include provision of allergen-reducing products and assessment of homes for environmental triggers. Medical Assistance members under the age of 21 or MinnesotaCare members under the age of 19 who have poorly controlled asthma are eligible for these benefits. The statute defines “poorly controlled asthma” as having had a hospital emergency department visit or hospitalization for asthma within the past year.

Reimbursement for the assessment and products requires an order from a licensed provider. Benefits must be billed through a provider enrolled with Minnesota Health Care Programs. Allergen-reducing products may be dispensed without the home assessment if a provider orders the products and certifies the need. Bill all allergen-reducing products under miscellaneous code E1399. Use modifier HA to denote you are billing for a child. A child includes those 21 and under but you must also follow MinnesotaCare and Medicaid policy for who is considered a child.

Home assessments will only be covered if provided by “a registered environmental health specialist or lead risk assessor currently credentialed by the Department of Health or a healthy homes specialist credentialed by the Building Performance Institute.” If no individual on staff at your facility has the required credentials, some local public health agencies provide home assessments.

For patients living in:

Home assessment is billed using the HCPCS code T2018 with the UA modifier. There is no service agreement with the T1028 modifier UA. The place of service (POS) is 12.

The “enhanced asthma care services” law can be found at: https://www.revisor.mn.gov/statutes/cite/256B.0625. See subdivision 67. The Department of Human Services has published a FAQ sheet with additional links.

For questions about this information, please email Health.asthma@state.mn.us.

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