Insurance: health insurers; collaborative care model for mental health care; provide for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406uu.

2025-2026 Regular Session Introduced by Noah Arbit and 7 co-sponsors

Michigan insurers must reimburse psychiatric collaborative care model services for mental health/SUD benefits using specific CPT/HCPCS codes.

bill electronically reproduced 06/25/2025

#insurance:healthinsurers #mentalhealth:other

Purpose / Intent

To require health insurers that deliver, issue for delivery, or renew health insurance policies in Michigan covering mental health and substance use disorder (SUD) benefits to reimburse services delivered using the psychiatric collaborative care model (CCM), by recognizing specific Current Procedural Terminology (CPT) / HCPCS billing codes for reimbursement.

Key provisions

Adds Section 3406uu to the Michigan Insurance Code.

Requires insurers offering mental health/SUD benefits to provide reimbursement for services delivered through the psychiatric collaborative care model using these billing codes:

CPT 90844
CPT 99492
CPT 99493
CPT 99494
HCPCS G2214

Directs the Insurance Director to update the list if the American Medical Association or other authorities alter or add CCM billing codes.

Allows an insurer to deny reimbursement for any listed code on the basis of medical necessity, provided:

Medical necessity determinations comply with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and its implementing regulations; and
Determinations follow the utilization review requirements in Michigan Insurance Code section 2212e.

Defines “psychiatric collaborative care model” by reference to the evidence-based integrated behavioral health delivery method described in federal register citation 81 FR 80230 (commonly involving care management in primary care, psychiatric consultation, measurement-based care, and systematic case review).

Who is affected

Insurers that issue, deliver, or renew health insurance policies in Michigan and that provide mental health and SUD benefits.

Providers using the collaborative care model (primary care clinicians, behavioral health care managers, psychiatric consultants) who bill the specified codes.

Patients receiving integrated behavioral health services in settings using the CCM.

Procedural status / timeline (selected)

Filed: March 12, 2025.

Committee activity: public hearing and substitute considered (April 22 & April 30, 2025); reported favorably as substituted (April 30, 2025).

Placed on General State Calendar and considered in May 2025; actions include postponements and being laid on the table subject to call.

Electronically reproduced: June 25, 2025. Referred to Committee on Insurance (introduced by Rep. Mike McFall).

Companion bill: SB 1177.

Potential impact / considerations

Seeks to expand insurer reimbursement for evidence-based integrated mental health care delivered in primary care settings, which may increase use of CCM and improve access to behavioral health.

Preserves insurer ability to deny coverage on medical necessity grounds consistent with MHPAEA parity rules and Michigan utilization review rules.

Operational impacts depend on insurer policy updates, provider billing readiness, and any future updates to CPT/HCPCS codes.

Bill