MedicaidBilling CodesHigh impact
Reimbursement available for Medicaid mental health screening assessments including telehealth
Priority Health·MI · Psychiatry, Family Medicine, Pediatrics +1 more·Claims & Billing
Effective date
Aug 3, 2026
We identified it
Aug 13, 2026
Summary
Priority Health Medicaid now reimburses mental health screening assessments (LOCUS and MichiCANS) conducted in person or via telehealth for eligible providers. Billing teams must use specific HCPCS codes with designated modifiers: H0027 with modifier Y for MichiCANS screener and H0031 with modifier WX for LOCUS assessment.
Action Required
By August 3, 2026: Billing team must update billing software and systems to recognize and accept HCPCS codes H0027 (with modifier Y) and H0031 (with modifier WX) for mental health screening assessments submitted to Priority Health Medicaid. Update claim submission templates and billing guidelines to reflect these approved codes only. Train billing staff on proper code and modifier application per Behavioral Health Billing Policy #054. Ensure telehealth claims are processed with the same codes when clinically appropriate. Failure to use correct codes and modifiers will result in claim denials. Refer staff to the Standardized Mental Health Assessment Guide from Michigan Department of Health and Human Services (MDHHS) for assessment and billing guidance.