Michigan's dual-track behavioral health, on one operating record.
Michigan runs specialty behavioral health through 10 regional PIHPs and mild-to-moderate care through Medicaid Health Plans, with the Mental Health Framework now standardizing LOCUS and MichiCANS assessments and CHAMPS billing. Navix is the operating record designed to feed those assessments and produce clean CHAMPS claims, and CollaborateMD, our RCM partner, processes the claims across payers.
Last verified: August 19, 2026 · sources belowDual-track routing, standardized assessments, CHAMPS.
Specialty behavioral health — serious mental illness, serious emotional disturbance, intellectual and developmental disabilities, and SUD — is managed by 10 regional PIHPs, which contract with county CMHSPsas their network. Mild-to-moderate outpatient mental health is the responsibility of the enrollee's Medicaid Health Plan. Providers on either track enroll and bill through CHAMPS.
The Mental Health Framework
For dates of service on and after October 1, 2025, providers serving Medicaid Health Plan enrollees must incorporate the state-designated LOCUS (adults) and MichiCANS Screener(youth) assessments, billed under Bulletin MMP 26-01. The Framework's FY2027 phase introduces the BH-COVER benefit flag to route each enrollee's mental health coverage to the health plan or the PIHP based on assessment results. BH-COVER is planned, not yet live.
CCBHC and a moving landscape
Michigan's CCBHC demonstration pays certified clinics a daily PPS-1 rate. The Framework rollout, CHAMPS enrollment rules for limited-license providers, and the state's PIHP procurement are all in motion, so verify current status before relying on any dated detail.
Two payers, standardized tools, a moving target.
- Dual-track routing: specialty care through your PIHP, mild-to-moderate through the Medicaid Health Plan
- Standardized LOCUS and MichiCANS assessments feeding payer routing, with specific CHAMPS billing codes
- CHAMPS enrollment rules and a Mental Health Framework rollout that is still moving through 2026 and 2027
The dual-track carve-out and the Framework rollout mean the same clinical work has to feed the right assessment, the right payer, and the right CHAMPS codes. The goal is one record that does all three without re-entry.
Assess, route, and bill from the same record.
Navix is the EMR your team works in, designed to structure documentation to support the standardized LOCUS and MichiCANS assessments and produce clean CHAMPS claims across the PIHP and Medicaid Health Plan tracks. CollaborateMD, our RCM partner, processes the claims across payers.
With the Framework and CHAMPS rules still moving through 2026 and 2027, keeping your own operating record means you adapt to routing and code changes without waiting on a county or plan system. Confirm current MDHHS requirements against the state's own materials.
Straight answers.
What is the difference between a PIHP and a CMHSP?
A Prepaid Inpatient Health Plan (PIHP) is the regional Medicaid managed-care entity MDHHS contracts with to administer the specialty behavioral health benefit; it holds the risk and manages the network. Community Mental Health Services Programs (CMHSPs) are the county-based programs inside that network that deliver services under the PIHP. Michigan has 10 PIHP regions.
What is MichiCANS?
The Michigan Child and Adolescent Needs and Strengths (MichiCANS) Screener is the state-designated standardized mental health assessment for enrollees birth through 18. Providers serving Medicaid Health Plan enrollees have been required to incorporate it, and LOCUS for adults, for dates of service on and after October 1, 2025. Under Bulletin MMP 26-01, the MichiCANS Screener bills as HCPCS H0002 with modifier 7Y and LOCUS as H0031 with modifier WX.
What is the Michigan Mental Health Framework?
It is MDHHS's two-year initiative (state fiscal years 2026 and 2027) to standardize assessments, referrals, and payer accountability across the Medicaid Health Plan and PIHP systems. Its FY2027 phase introduces a benefit-plan flag (BH-COVER) intended to assign each enrollee's mental health coverage to the health plan or the PIHP based on assessment results. Treat BH-COVER as planned rather than live, and confirm current status with MDHHS.
How does CCBHC PPS-1 billing work?
Under Michigan's CCBHC demonstration, a certified clinic bills a single clinic-specific daily rate (PPS-1) for all CCBHC services furnished to a person on a given day, rather than fee-for-service per procedure. The rate is cost-based and set per clinic, and CCBHCs carry heavy quality, cost-report, and staffing obligations.
How does Navix fit Michigan's requirements?
Navix is your operating EMR, designed to structure documentation to support the standardized LOCUS and MichiCANS assessments and produce clean CHAMPS claims across the dual-track system. CollaborateMD, our RCM partner, processes the claims across the PIHP, the Medicaid Health Plan, and other payers. Confirm current CHAMPS and Framework requirements with MDHHS, which change month to month.
Related.
See Navix on Michigan's dual-track system.
We will walk the path from assessment to CHAMPS claim across the PIHP and health-plan tracks, on a real chart.
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