MedicaidCoverageMedium impact
MMP 25-56: Updates to the Medicaid Provider Manual; OT/ST/PT for Beneficiaries with Autism Spectrum Disorder Clarification; Electronic Health Record (EHR) Incentive Program for Hospitals
Michigan Medicaid - MDHHS·MI · Occupational Therapy, Physical Therapy, Speech Therapy +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Michigan Medicaid updated its provider manual with clarifications on OT/PT/ST coverage for autism spectrum disorder beneficiaries, requiring coordination between behavioral health and physical health providers when services are provided concurrently. The EHR Incentive Program for Hospitals section was removed as the program ended in 2019.
Action Required
By January 1, 2026: Therapy providers treating Medicaid beneficiaries with autism spectrum disorder must ensure proper coordination between PIHP behavioral health services and MHP/FFS physical health services. Document distinct goals for each therapy type when providing concurrent services. Update billing workflows to verify beneficiary eligibility determination by PIHP before billing MHP or FFS for ASD-related therapy services.