EIDBI provider requirements in Minnesota are set by Minn. Stat. § 256B.0949, the statute that created the Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit. The statute defines who can receive the service, who can evaluate the person, who can plan and deliver treatment, and what the agency itself must do to stay enrolled with Minnesota Health Care Programs (MHCP).
As of September 2026 there are three layers to get right. The first is people: the qualified supervising professional (QSP), the comprehensive multi-disciplinary evaluation (CMDE) provider, and Level I, II, and III treatment providers, each with education and supervised-hour thresholds in subd. 15. The second is the agency: supervision minimums, background studies, and the January 1, 2026 rule that every QSP must be an employee. The third is enrollment status: a moratorium on new EIDBI agencies, a provisional license deadline that has already passed, and the Minnesota Revalidate 2026 process.
This guide walks through each layer with the statute sections and DHS notices behind it. If you need the benefit itself explained first, start with the What is EIDBI guide. Billing and documentation are covered in the EIDBI billing codes guide and the EIDBI documentation guide.
Who is eligible for EIDBI?
Under § 256B.0949, subd. 2 and 3, a "person" is an individual under 21 years of age. To receive EIDBI the person must be enrolled in Medical Assistance, have a diagnosis of autism spectrum disorder (ASD) or a related condition that meets the statutory criteria, and have a CMDE that finds the service medically necessary.
A related condition is defined narrowly. It must be severe and chronic, produce impairment of adaptive behavior and function similar to ASD, require treatment similar to ASD treatment, and result in substantial functional limitations in three core areas: social or interpersonal interaction, functional communication, and restrictive or repetitive behaviors or hyperreactivity or hyporeactivity to sensory input. A diagnosis alone does not establish eligibility; the CMDE does.
The CMDE and who can complete it
The CMDE is the evaluation that determines medical necessity. Under subd. 5 it must include an assessment of the person's developmental skills, functional behavior, needs, and capacities based on direct observation, medical information from a physician, advanced practice registered nurse, or physician assistant, and input from family, school personnel, and child care providers where available. It also records the legal representative's or caregiver's preferences for involvement and the treatment modalities available.
Subd. 5a sets who may perform it. A CMDE provider must be a licensed physician, advanced practice registered nurse, physician assistant, mental health professional, or qualifying clinical trainee, with at least 2,000 hours of clinical experience in evaluating and treating people with ASD or a related condition, or equivalent graduate coursework in ASD diagnostics, ASD treatment strategies, and typical child development. A CMDE provider enrolls with MHCP directly, does not need to be affiliated with an EIDBI agency, and does not need a QSP on the claim.
EIDBI provider levels and qualifications
Subd. 15 sets the qualifications for each role. The table below summarizes the pathways as they appear in the statute and in Minnesota's approved Medicaid state plan (Attachment 3.1-A, TN 23-17). Where a pathway lists supervised hours, the hours are of supervised clinical experience or training in examining or treating people with ASD or a related condition unless noted.
| Role | Core requirement | Pathways |
|---|---|---|
| QSP | Overall responsibility for treatment planning, supervision, progress monitoring, and treatment review | Licensed mental health professional or licensed behavior analyst with at least 2,000 supervised hours or equivalent graduate coursework; or a developmental or behavioral pediatrician meeting the same threshold |
| Level I | 2,000 supervised hours or equivalent graduate coursework, plus one of the listed credentials | Master's degree (or enrolled in a master's program with monthly QSP observation and direction until 2,000 hours) in a behavioral health, child development, or allied field; bachelor's degree plus advanced certification in a DHS-recognized modality; board certified behavior analyst; board certified assistant behavior analyst with 4,000 supervised hours; or bachelor's degree plus 6,000 hours of early intervention experience in the agency's modality and Level III training |
| Level II | One of the listed combinations of education and supervised hours | Bachelor's degree in a behavioral or child development field with 1,000 supervised hours or equivalent graduate coursework; associate's degree with 2,000 supervised hours; 4,000 supervised hours; graduate student in a related field under QSP supervision; enrolled in a bachelor's program with QSP or Level I observation and direction at least twice per month until 1,000 hours; or age 18 or older, fluent in a language other than English or certified by a Tribal government, Level III training complete, and weekly observation and direction until 1,000 hours |
| Level III | Age 18 or older and the department's Level III training requirements | Plus one of: a high school diploma or GED; fluency in a language other than English or Tribal government certification; or one year of experience within the previous five years as a personal care assistant, community health worker, waiver service provider, or special education assistant to a child with ASD or a related condition |
Two details trip up personnel files. First, hours worked as a mental health behavioral aide or Level III provider count toward the Level II experience pathways, so keep dated records of those hours. Second, every Level I, II, and III provider must be employed by an EIDBI agency; the state plan repeats "employed by an EIDBI agency" at each level.
Compliance note: subd. 17 lets the commissioner grant exceptions to provider qualifications where a shortage exists and the exception would not compromise safety or treatment effectiveness. An exception must be granted, not assumed. Keep the approval in the personnel file with the dates it covers.
Required EIDBI trainings
DHS requires individual Level III providers to complete three trainings: ASD Strategies in Action, EIDBI 101, and Multicultural 101. DHS recommends completing them within six months of enrolling with MHCP and recommends the same trainings for all other qualified EIDBI providers. Because Level III qualification under subd. 15 depends on meeting the department's Level III training requirements, the completion certificates are part of the evidence that a provider was qualified on each date of service.
Agencies should also keep the training records that support the Level I and Level II pathways that reference "Level III training requirements", since those pathways cannot be verified without them.
Agency duties: supervision, observation and direction, and background studies
Subd. 16 lists what an enrolled EIDBI agency must do. The items that reviewers check most often are:
- Clinical supervision of at least one hour for every 16 hours of direct treatment per person, unless the person's individual treatment plan (ITP) authorizes otherwise.
- Observation and direction at least once per month, delivered by qualified staff. No more than two consecutive monthly required observation and direction sessions may be conducted via telehealth.
- A designated compliance officer and records that verify each service delivered.
- Background studies through NETStudy 2.0. DHS provider news from January 2026 adds that each EIDBI location must hold its own NETStudy 2.0 Agency ID (requested on form DHS-3891A). Since August 5, 2025, an individual EIDBI provider must have a completed background study with an eligible or set-aside result for each location before providing services, and must complete a new fingerprint study each time they affiliate with a different agency.
The January 1, 2026 QSP employee rule
Effective January 1, 2026, all QSP EIDBI providers must be EIDBI agency employees under § 256B.0949, subd. 2. DHS defines an employee as a person employed temporarily, part time, or full time by the agency that submits claims for the work. The definition excludes independent contractors who file a 1099, billing agencies and consultants who do not provide EIDBI services, and people who perform work for fewer than 80 hours in a 12-month period. QSPs attest to employment by submitting the EIDBI QSP Assurance Statement, DHS-7120C. If your agency shared a contracted QSP across several companies, that model ended on January 1, 2026. The EIDBI QSP requirements guide covers the QSP's duties, supervision minimums, and the enrollment form in detail.
The moratorium and the provisional license
Enrollment status is now as important as qualifications. As of September 2026 there are three overlapping actions:
| Action | Dates | What it means |
|---|---|---|
| EIDBI agency enrollment moratorium | November 1, 2025 through October 31, 2026 | DHS will not enroll new EIDBI provider agencies. Agencies enrolled before November 1, 2025 may enroll new locations; individual EIDBI providers may still enroll |
| Enrollment freeze for 13 services | From January 27, 2026; extended in July 2026 through January 27, 2027 | EIDBI agencies are one of the 13 categories. Exceptions require written CMS approval. Enrolled providers keep serving clients |
| Provisional licensure under § 245A.142 | Applications due May 31, 2026; DHS decisions by December 31, 2026 | Agencies that did not apply may not operate from June 1, 2026 and are disenrolled. License holders must identify controlling individuals, disclose billing agencies and consultants, keep training and quality assurance policies, and document contractor agreements |
For anyone planning a new autism services company, the practical answer is that there is no path to a new EIDBI agency enrollment until the moratorium and the freeze lift. The guide to starting a care agency in Minnesota covers which service lines remain open. Enrolled agencies should also expect enforcement under subd. 18, which allows unannounced inspections and lets the commissioner withhold payment or suspend or terminate an agency's enrollment for noncompliance.
Minnesota Revalidate 2026 obligations for existing agencies
In January 2026 DHS designated EIDBI agencies a high-risk provider type subject to enhanced screening, and launched Minnesota Revalidate 2026 on January 26, 2026 under a corrective action plan with the Centers for Medicare & Medicaid Services. About 5,583 providers of high-risk services had to revalidate by May 31, 2026. Revalidation runs through the Minnesota Provider Screening and Enrollment (MPSE) portal and includes credential verification, fingerprint-based background studies for direct and indirect owners, unannounced site visits, and updated enrollment records. Providers that did not complete revalidation by the deadline face termination from MHCP.
For an EIDBI agency the revalidation checklist and the provisional license checklist overlap: controlling individuals, background study numbers for every owner and authorized person, each location's Agency ID, and the QSP employment attestation. The Minnesota Revalidate guide walks through the portal steps. EIDBI is also one of the 14 services under DHS pre-payment review, so a claim can be held until the record behind it is produced.
How Trustora helps
Trustora keeps EIDBI provider qualifications next to the services they support. Each staff record stores the provider level, licenses, supervised-hour totals, training certificates, background study results by location, and the QSP employment attestation, and the platform flags a session when the rendering provider's level or supervision status does not match the service. Supervision and observation and direction sessions are logged against the one-hour-per-16-hours and monthly minimums so the agency can show the ratio for any person and any date range.
The one-click DHS audit binder assembles personnel qualifications, supervision logs, and the treatment record for a site visit, a revalidation request, or a pre-payment review. See the platform overview for the EIDBI module, and the EIDBI documentation guide for what the clinical record must contain.