Determining who is responsible for providing Mental Health and Substance Abuse Services to Medicaid beneficiaries depends upon the severity of their needs and whether the beneficiary is enrolled in a particular program.
For persons enrolled in Medicaid Fee-for-Service, their mental health benefit is described in the Practioner chapter of the Medicaid Provider Manual. These services are provided by various mental health processionals and are designed to treat beneficiaries with mild to moderate mental health needs. These professionals also help maintain beneficiaries with stable mental health conditions.
Medicaid Beneficiaries with more involved or severe mental health conditions that are not likely to respond to traditional outpatient treatment need to be referred to the Specialty mental health and substance abuse carve out provider system. Not only are the providers in this system in a position to provide more specialized inpatient and outpatient mental health services but they are also the gate way for all Medicaid substance abuse treatment services.
For those not enrolled in the Medicaid program, there is a public mental health and a substance use disorder service network that can be accessed. Mental health services are available statewide through the local government community mental health services program. They are also responsible for providing all MIChild and Adult Benefit Waiver mental health services. Similarly, the Substance Abuse Coordinating Agency system provides services to the general public and is also responsible for providing the substance use disorder treatment benefits to both MIChild and Adult Benefit Waiver enrollees.
Fee for Service Information
|Communications and Training gives access to Provider Update newsletters, numbered letters, information on training opportunities, etc.
||Prior Authorization gives access to the Medicaid Nursing Facility Level of Care Determination tool.
|Get information about Policy and Forms like the Medicaid Provider Manual, draft and final policy bulletin, etc.
||Waivers includes information related to current and proposed Medicaid waivers.
In Billing and Reimbursement , find information necessary for claim submission, including billing tips, provider-specific procedure code databases (including fee screens), electronic billing information, Sanctioned Provider list, Beneficiary Co-Payment Requirements, Third Party Liability, etc.