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MedicaidReimbursementMedium impact

MSA 20-08

Michigan Medicaid - MDHHS·MI · Psychiatry·Provider Bulletin
Effective date
Feb 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid increased reimbursement rates to 100% of Medicare rates for psychiatric diagnostic evaluation services (CPT 90791 and 90792) for patients under 21 years old, effective February 1, 2020. This rate increase applies to Medicaid, Healthy Michigan Plan, and MIChild programs.

Action Required

Action needed
Immediately: Billing team should verify that Michigan Medicaid claims for CPT 90791 and 90792 for patients under 21 are being reimbursed at the updated 100% Medicare rate. Review recent claims and resubmit any underpaid claims from February 1, 2020 forward. Update fee schedules in billing system to reflect new rates.

Affected Billing Codes

90791
90792