Minnesota Rule chapter 5221
What kind of treatment does workers' comp cover?
These pages map the state treatment parameters: the usual duration or count, the listed ways to go longer, and the rule part that changes by body region. They are not a coverage verdict. Verified against the Revisor text through 2026-08-19.
When the insurer has to answer
Seven days to answer
For departures, inpatient surgery, some chronic programs, and certain equipment, the treating provider must notify the insurer at least seven working days before the care starts. The rule then gives the insurer seven working days to approve, deny in writing, ask for more records, require a second surgical opinion, or schedule an employer IME. For non-emergency surgery, the statute is tighter: the insurer must answer in writing within seven calendar days.
Minn. R. 5221.6050, subp. 9.A and 9.C; Minn. Stat. § 176.135, subd. 1a(a)
Complete silence counts as authorization
If the provider hears nothing for seven working days after proper notice, authorization is deemed given. If the insurer affirmatively authorizes care, it generally may not later refuse to pay that authorized treatment.
Minn. R. 5221.6050, subp. 9.C, items (1) and (2)
An IME or second-opinion request is not a denial
A second-opinion request, an employer IME under Minn. Stat. § 176.155, or a demand for more records is not a denial. Non-emergency surgery usually waits while those steps run. Workers' comp is primary for work-injury treatment under Minn. Stat. § 176.135, subd. 1, so group health is not a practical backup. Many providers will not schedule major care until someone with a comp claim number accepts financial responsibility. That is the gap: no surgery, no health-plan bill, and no denial letter to file on.
Minn. R. 5221.6050, subp. 9.C, items (5), (6), and (7); Minn. Stat. § 176.135, subd. 1
Forty-five days after an employer IME on surgery
When prior notification of non-emergency surgery is required and the insurer timely requests an employer examination, the surgery may not be performed pending that exam. After 45 days from the insurer's exam request, the surgeon may elect to proceed, subject to a later compensability decision. That is when the stall is usually ripe to file a Medical Request. DLI can decide the fight at a conference if the amount in dispute is $7,500 or less; a larger surgery dispute can be certified to OAH.
Minn. R. 5221.6050, subp. 9.C, item (6); Minn. Stat. § 176.106, subds. 1 and 3
When there is an actual denial
A written denial triggers the medical dispute path: request the insurer's internal review, or file a Medical Request with DLI attaching the provider's notice and the insurer's response. That route applies when liability for the injury itself is not in dispute. A primary liability fight still belongs in a Claim Petition at OAH.
Minn. R. 5221.6050, subps. 7.C and 9.C, item (3); Minn. Stat. § 176.106
Chiropractic
Does Minnesota workers' comp cover chiropractic?
12 weeks of clinic care from the first passive visit
Clinic chiropractic and osteopathic manipulation are a passive modality. For low back, neck, thoracic, and upper-extremity injuries the rule allows up to five visits a week for the first one to two weeks, then a taper, with a 12-week clinic duration from the first passive modality.
Physical therapy
How long will Minnesota workers' comp pay for physical therapy?
12 weeks of clinic passive care; active care can continue past that if its own cap is not exceeded
Heat, ultrasound, TENS, massage, and other clinic passive modalities share the 12-week clinic cap. Active exercise can continue after that 12-week passive cap so long as the active modality's own maximum is not exceeded. Occupational therapy is named in the same regional parts as a care setting, not as a separate duration table.
Imaging
When will Minnesota workers' comp pay for an MRI?
No routine MRI or CT in the first 8 weeks after a low-back injury, except listed emergencies
Imaging has to follow general rules first: history and exam before ordering, one most-effective study, no imaging solely to rule out a diagnosis that is not seriously in play, and no repeat of the same study except listed reasons. For low back pain, MRI and CT are not indicated in the first eight weeks except for conditions such as suspected cauda equina, progressive neurologic deficit, or a suspected bony lesion.
Injections
How many epidural injections will Minnesota workers' comp cover?
Epidural: 3. Trigger point: 4 per site. Facet: 3 per site. RFA: 2 per site.
Therapeutic injections can run past the 12-week passive cap if the injection maximum is not exceeded. They have to be given with active treatment directed to the same site. Prolotherapy and botulinum toxin are not indicated for low-back or neck problems.
Surgery
Does the surgeon have to notify the insurer before Minnesota work-comp surgery?
Prior notification at least 7 working days before non-emergency inpatient surgery or a parameter departure
Non-emergency inpatient surgery requires prior notification at least seven working days before admission. The treatment-parameter rule then gives the insurer seven working days to approve, deny, ask for records, require a second opinion, or request an employer IME. Minn. Stat. § 176.135, subd. 1a, uses seven calendar days for that written surgery response. Emergency surgery does not need advance notice.
Work conditioning
How long is a Minnesota work-hardening program under workers' comp?
6 weeks; more time needs a new prior notification
Work conditioning and work hardening are job-oriented programs used in chronic management. The first treatment period is six weeks. Another period needs a new prior notification and a record of attendance and progress, or a change in the target job.
Pain program
What is the Minnesota workers' comp limit on a chronic pain program?
20 eight-hour days over 4 weeks, plus up to 12 aftercare sessions; one completed program per injury
A chronic pain management program is a multidisciplinary course for chronic pain syndrome. Initial treatment is capped at 20 eight-hour days over four weeks. Aftercare is capped at 12 sessions. Only one completed program is indicated for an injury.
Opioids
What are the Minnesota workers' comp opioid prescribing limits?
Acute: 2 weeks per prescription in the first 4 weeks. After 4 weeks: 1 month per prescription. Long-term daily use: 90-day contract path. 120 MME/day triggers extra review.
Oral opioids in the first four weeks after injury are limited to two weeks of medication per prescription. After four weeks, a prescription may not exceed one month of medication. Daily use for at least 90 days is long-term treatment and requires a written contract and monitoring. More than 120 morphine-equivalent milligrams a day triggers enhanced review.
PTSD
What PTSD treatment does Minnesota workers' comp cover?
16-week psychotherapy periods, no more than twice a week except emergency care
PTSD has its own parameter part. A psychotherapy period starts with the first indicated modality and ends 16 weeks later. Treatment under the listed trauma-focused modalities is not indicated more than twice a week except emergency care. Additional 16-week periods are allowed when the worker still meets PTSD criteria and the part's conditions are met.
Inpatient
Does Minnesota workers' comp require notice before a hospital stay?
Prior notification at least 7 working days before non-emergency inpatient care
A stay is inpatient if the patient spends at least one night in the facility. Non-emergency inpatient hospitalization requires the same seven-working-day prior notification as inpatient surgery. Clinical criteria for admission live in Minn. R. 5221.6400.