Proposed Skilled Maintenance Policy Change (SNF)

The Michigan Department of Health and Human Services (MDHHS) issued a proposed policy that modifies the billing requirements for skilled maintenance therapy and updates benefit maximums for services performed in outpatient and nursing facility settings effective January 1, 2024. Under the policy for dates of services on and after January 1, 2024, Medicaid would no longer require outpatient and nursing facility skilled maintenance therapy to be reported under a therapy re-evaluation procedure code. Therapists would report maintenance services under select therapeutic procedure codes. When reporting services under a time-based procedure code, the four sessions should not exceed a total of 16 units per 60- or 90-day applicable period. If more than 16 units or four sessions are required with the applicable period, the therapist must request prior authorization. You may send supporting or opposing comments for the proposed change to HCAM at [email protected] or directly to the state at [email protected].