MMP 26-29: Certified Community Behavioral Health Clinic (CCBHC) Demonstration Direct Payment Transition
Summary
Michigan's MMP 26-29 bulletin updates provider enrollment, billing and reimbursement requirements for the Certified Community Behavioral Health Clinic (CCBHC) Demonstration for the payment model transition, effective October 1, 2025. CCBHCs must enroll as a CCBHC provider type with a Type 2 NPI specific to CCBHC services, and a service is recognized as a CCBHC service only when the claim includes HCPCS code T1040, the qualifying CCBHC HCPCS or CPT code, and a qualifying diagnosis. CCBHCs bill a clinic-specific PPS-1 daily rate, which is paid only for Medicaid-eligible beneficiaries, and services delivered by a designated collaborating organization must be submitted with identifying DCO information in loop 2310C or 2420C.
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