MedicaidCoverageMedium impact
MMP 23-49: Substance Use Disorder Services - Hospital Physician Consultations
Michigan Medicaid - MDHHS·MI · Emergency Medicine, Internal Medicine, Psychiatry +2 more·Specialty Services
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Michigan Medicaid now covers substance use disorder (SUD) consultation services provided by physicians and qualified practitioners in hospital and emergency department settings, effective January 1, 2024. These consultations include assessment, medication-assisted treatment management, and discharge planning for patients with co-occurring SUDs during hospital stays. No prior authorization is required for these services.
Action Required
By January 1, 2024: Billing team must update systems to allow SUD consultation billing for hospital and ED settings under Michigan Medicaid programs. Ensure claims include SUD primary diagnosis and collaborating physician information when applicable. Train providers that no prior authorization is needed for these consultation services. Update encounter forms to capture required elements for SUD consultations.