MedicaidCoverageMedium impact
MMP 26-17: Reimbursement of Specialty Behavioral Health Services Based Upon Location of Services
Michigan Medicaid - MDHHS·MI · Psychiatry, Pediatrics·Claims & Billing
Effective date
Jul 1, 2026
We identified it
Jun 16, 2026
Summary
Michigan Medicaid policy MMP 26-17 clarifies reimbursement rules for specialty behavioral health services based on service location, affecting mental health, I/DD, and SUD treatment billing. The policy specifies coverage limitations for services in nursing facilities, child caring institutions, and therapeutic group homes, with different rules for children with SED versus I/DD.
Action Required
By July 1, 2026: Billing teams providing behavioral health services must review and update billing procedures for services delivered in nursing facilities (limit to 6 specific clinic services only), child caring institutions (verify licensing requirements and funding sources), and therapeutic group homes (ensure compliance with bed capacity limits). Update prior authorization workflows to verify service location requirements and coordinate with PIHPs/CMHSPs for proper authorization documentation.