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Michigan Medicaid - MDHHSMedicaid · Coverage · Claims & Billing · MI · Pediatrics, Dentistry, PsychiatryMedium impact

MMP 26-48: Implementation of Requirements of Section 5121 of the Consolidated Appropriations Act (CAA) of 2023 - Services Coverage and Reimbursement

Effective date
Dec 1, 2026
Identified
Oct 31, 2026

Summary

Effective December 1, 2026, Michigan implements Section 5121 of the Consolidated Appropriations Act of 2023 for Medicaid, CHIP and the Healthy Michigan Plan, covering screening, diagnostic and Targeted Case Management (TCM) services for eligible justice-involved individuals. Pre-release services fall under the new REENTRY-MA benefit plan for the 30 days before release, and post-release TCM falls under the expanded TCM-INC benefit plan, covering up to one year after release. Eligible individuals must be post-adjudication, within 30 days of scheduled release, and either under 21 or in the former foster care group up to age 26.

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What to do

Action · 9 steps
01Before December 1, 2026: Billing team: Confirm that every provider who will bill is enrolled in CHAMPS, that Type 1 individual providers are associated with a Type 2 organization provider, and that organization providers have obtained an NPI and completed the relevant Application and Attestation form(s).
02Confirm the facility is Medicaid-enrolled and has an NPI, obtaining one if it does not.
03Confirm that pre-release services are reimbursable only when the individual is enrolled in REENTRY-MA, and that post-release TCM is reimbursable only when the individual is enrolled in TCM-INC.
04The eligible facility must confirm before release that the benefit plan has been updated, and the post-release case manager must validate it before delivering TCM services.
05Bill post-release TCM according to the billing requirements for the setting where the service occurs (FQHCs and CCBHCs bill under their own billing requirements).
06Use the CAA Reentry Services Fee Schedule posted on the MDHHS Billing and Reimbursement webpage under 'CAA Reentry Service Providers' for reimbursement.
07Providers: Record the comprehensive assessment information the bulletin lists in the individual's medical record.
08Comprehensive assessments are limited to one visit per eligible individual per period of eligibility, and monitoring is limited to three monitoring and three follow-up visits per individual.
09If an individual is released earlier than expected, share the care plan with the post-release case management entity within one business day of release and conduct the warm handoff within one week.

Original notice

MMP 26-48: Implementation of Requirements of Section 5121 of the Consolidated Appropriations Act (CAA) of 2023 - Services Coverage and Reimbursement
michigan.gov · Always check the source before changing claims.
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Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesPediatricsDentistryPsychiatry

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