MedicaidCoverageMedium impact
MSA 21-20
Michigan Medicaid - MDHHS·MI · Psychiatry, Pediatrics·Provider Bulletin
Effective date
Sep 1, 2021
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has issued new requirements for Behavioral Health Treatment (BHT) services for children with Autism Spectrum Disorder, including specific eligibility criteria, person-centered planning requirements, and comprehensive assessment protocols. Providers must ensure proper medical necessity documentation, implement individualized plans of service, and follow new transition/discharge criteria.
Action Required
Before September 1, 2021: Billing and clinical teams must update workflows to ensure BHT services for ASD patients under 21 meet new eligibility criteria including qualified practitioner diagnosis and medical necessity determination. Implement person-centered planning (PCP) process with annual IPOS reviews. Update documentation templates to capture required behavioral assessments using ABA methodology. Establish coordination protocols with schools/early intervention programs. Train staff on new transition/discharge criteria and step-down planning requirements.