MedicaidAdministrativeHigh impact
MMP 26-30: Enrollment of Limited Licensed Non-Physician Behavioral Health Providers and Updated Billing Requirements; Updates to Fee-for-Service (FFS) Program Billing of Level of Care Utilization System (LOCUS) and Michigan Child and Adolescent Needs and Strengths (MichiCANS) Screener Assessments
Michigan Medicaid - MDHHS·MI · Psychiatry, Family Medicine, General Practice +1 more·Prior Authorization
Effective date
Sep 1, 2026
We identified it
Aug 1, 2026
Summary
Michigan Medicaid expands enrollment of limited licensed behavioral health providers (Master's level TLLPs, Limited Licensed Counselors, Educational Limited Licensed Marriage & Family Therapists, and Limited Licensed Master's level Social Workers) effective September 1, 2026. These providers must now enroll individually in CHAMPS, be uniquely identified on claims with their individual NPI in the rendering provider field, and work under supervision of a fully licensed provider. Additionally, FFS beneficiaries' LOCUS and MichiCANS Screener Assessments are now covered when performed by qualified providers.
Action Required
By November 1, 2026: All currently enrolled limited licensed behavioral health providers under 'Managed Care Only' specialties must report their supervising provider's NPI and associate themselves to their supervisor in CHAMPS to avoid disenrollment and claim denials. Billing team must immediately update billing software and claim submission processes: (1) Ensure all limited licensed provider claims include the individual NPI (not supervisor's NPI) in the Rendering Provider field on professional claims effective September 1, 2026; (2) For institutional/outpatient hospital claims, include supervisor's NPI in Attending Provider field and limited licensed provider's NPI in Other Provider/Rendering Provider field; (3) For FQHC/RHC/THC claims, bill on institutional form using clinic's Type 2 NPI with supervisor's individual NPI in Attending Provider field and limited licensed provider's NPI in Other Provider/Rendering Provider field; (4) Update credentialing files to require individual NPI enrollment confirmation and active supervising provider association for all behavioral health billing providers; (5) Configure system edits to reject claims submitted under supervisor's NPI for dates of service on/after September 1, 2026. Consequences of inaction: Claims submitted with incorrect provider identifiers will be denied, causing revenue loss and processing delays.