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.
Summary
House Bill 4685 would amend Michigan’s Insurance Code to require health insurers that cover mental health and substance use disorder benefits to reimburse services delivered through the psychiatric collaborative care model. The bill specifically identifies several Current Procedural Terminology (CPT) billing codes that must be covered, including 90844, 99492, 99493, 99494, and G2214. It also directs the insurance director to update the list if those billing codes change over time.
The bill defines the psychiatric collaborative care model as an evidence-based, integrated behavioral health delivery method referenced in federal guidance. In practical terms, the measure is intended to support coordinated care between primary care and behavioral health providers by ensuring insurers pay for these services when they are part of covered mental health or substance use disorder benefits. The bill preserves an insurer’s ability to deny reimbursement on medical necessity grounds, but only if those determinations comply with federal mental health parity law and Michigan’s utilization review requirements.
Impact
HB4685 would add a new section 3406uu to the Michigan Insurance Code, creating a statutory reimbursement mandate for psychiatric collaborative care services in health insurance policies that include mental health and substance use disorder benefits. It would affect insurers operating in Michigan, as well as providers billing under the listed CPT codes, by requiring coverage and payment for these integrated behavioral health services subject to medical necessity review. The bill would also tie state insurance practice to federal parity standards and require administrative updating of billing codes as the AMA and federal guidance evolve.
Sentiment
Based on the bill text and available context, the bill appears to have a generally supportive policy intent focused on expanding access to mental health care and improving reimbursement for integrated behavioral health services. No committee transcript or vote data is available in the provided materials, so there is no recorded public debate or formal legislative sentiment to summarize beyond the bill’s apparent pro-access, pro-provider reimbursement purpose.
Contention
The main potential point of contention is cost and utilization: insurers may object to a new mandatory reimbursement requirement, while supporters are likely to emphasize improved access to evidence-based mental health treatment and better integration of behavioral health into primary care. Another possible issue is the scope of medical necessity review, since the bill allows denials only when consistent with federal parity law and state utilization review rules, which may raise questions about how much discretion insurers retain. No specific objections or amendments are documented in the provided context.