The Billing Corner

MI Child and Mental Health Billing

MI Child and Mental Health Billing

This question comes in from one of our centers:

Q: For mental health MIChild funding that was given to CMHs on a per-capita rate: Under this agreement, they should be seeing acute and mild cases that present; however, in my experience severity criteria are still used in gate keeping. Is there any way for a School-Based Health Center to Bill Mental Health and/or Substance abuse services when the patient has MI Child?

A: Today, under the current state contracts for MI-Child, school-based health centers will not be paid for behavioral health services provided by a behavioral health specialist.

Those services are supposed to be provided by CMH, (we all know that it is difficult for kids to get in CMH to be seen), so our health centers still see those kids without getting reimbursed from the payer.

The state is currently in a re-bid process (meaning the state is putting up for contract re-bids with all health plans, to be a managed care provider for state Medicaid, and May 1 is when the applications will be available to the health plans, which will be effective starting next year), they are blending Mi-Child in that process, and they will have the same benefits as all other Medicaid plans (Healthy Michigan, Medicaid Managed Care, etc.).   This will allow for better care coordination for the patient.  When that happens, school-based health centers will be able to bill and receive payment for the behavioral health services provided to Mi-Child patients.

Leave a Reply