MedicaidCoverageMedium impact
MSA 21-19
Michigan Medicaid - MDHHS·MI · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Aug 1, 2021
We identified it
Jun 20, 2026
Summary
Michigan Medicaid now allows primary care providers (without specialty SUD contracts) to bill fee-for-service Medicaid for alcohol and opioid use disorder treatment services. This expands access by enabling office-based providers to receive reimbursement for AUD/OUD evaluation, psychotherapy, drug testing, SBIRT services, and medications through standard Medicaid billing.
Action Required
For Michigan providers treating Medicaid patients: Verify you meet provider qualifications (licensed, enrolled in CHAMPS, not excluded from Medicaid). Update billing procedures to submit AUD/OUD treatment claims to Medicaid fee-for-service instead of PIHPs when treating patients with primary diagnoses of alcohol or opioid use disorders. Ensure documentation meets ASAM criteria for outpatient treatment and includes appropriate ICD-10 diagnoses. Providers with existing PIHP contracts must continue billing through PIHP.