Email, Phone & Fax
The CPT® Editorial Panel is deleting audio-only CPTs 99441-99443 effective 12/31/2024. For services provided on and after January 1, 2025, providers must report the evaluation and management (E/M) code that best represents the services being provided. In accordance with current Medicaid policy, providers must include the appropriate place of services (POS) code that would be reported as if the beneficiary were in-person for the visit, along with modifier 93 (audio-only telemedicine) or modifier 95 (audio-visual telemedicine). Prepaid Inpatient Health Plan (PIHP) and Community Mental Health Services Program (CMHSP) providers must report POS 02 or 10, as applicable, per MMP 23-10. Please refer to the “Place of Service (POS), Modifier 95 and Modifier 93” section of the Michigan Medicaid Policy (MMP) 23-10, Telemedicine fee schedules, and the “Telemedicine” chapter of the Medicaid Provider Manual for further details/requirements related to audio-visual and audio-only telemedicine services.
Telemedicine services are covered both when a distant provider’s synchronous interactions occur using an audio and video electronic media or when using an audio-only electronic media.
SOURCE: MI Compiled Laws Sec. 400.105h (Accessed Apr. 2025).
MDHHS supports the use of simultaneous audio/visual telemedicine service delivery, as a primary method of telemedicine service, but in situations where the beneficiary cannot access services via a simultaneous audio/visual platform, either due to technology constraints or other concerns, MDHHS will allow the provision of audio-only services for a specific set of procedure codes.
Additional guidelines for audio-only service include:
- Visits that include an assessment tool—the tool must be made available to the beneficiary and the provider must ensure the beneficiary can access the tool.
- When a treatment technique or evidence-based practice requires visualization of the beneficiary, it must be performed via simultaneous audio/visual technology.
- Audio-only must be performed at the preference of the beneficiary, not the provider’s convenience.
- Privacy and security of beneficiary information must always be established and maintained during an audio-only visit.
To effectuate this in perpetuity, MDHHS will publish audio-only databases that will include all codes MDHHS is permitting via audio-only. These databases will be created for both FFS/MHP providers and for those providers within the PIHP/CMHSP system and will be maintained on the MDHHS website. MDHHS will, on a regular and ongoing basis, assess the audio-only databases and will add/remove codes as needed. Some of the criteria used to determine addition/removal from the audio-only database include provider/stakeholder feedback, new coding guidelines, utilization data and quality reports.
All audio-only telemedicine services, as represented on the audio-only telemedicine fee schedule and submitted on the professional invoice, must be reported with the Place of Service (POS) code that would be reported as if the beneficiary were in-person for the visit along with modifier 93 – “Synchronous Telemedicine Service rendered via telephone or other real-time interactive audio-only telecommunications system”.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2202, 2206-2207, Apr. 1, 2025, (Accessed Apr. 2025).
For services submitted on the institutional invoice, the appropriate National Uniform Billing Committee (NUBC) revenue code, along with the appropriate telemedicine CPT/HCPCS procedure code and modifier 95 or modifier 93, must be used.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2206, Apr. 1, 2025, (Accessed Apr. 2025).
Behavioral Health – PIHP/CMHSP
In addition to the Determination of Appropriateness/Documentation section of this policy, the Bureau of Specialty Behavioral Health Services would like to reiterate that services delivered to the beneficiary via telemedicine be done at the convenience of the beneficiary, not the convenience of the provider. In addition, these services must be a part of the person-centered plan of service and available as a choice, not a requirement, to the beneficiary.
If the individual (beneficiary) is not able to communicate effectively or independently they must be provided appropriate on-site support from natural supports or staff. This includes the appropriate support necessary to participate in assessments, services, and treatment.
The PIHP/CMHSP must guarantee the individual is not being influenced or prompted by others when utilizing telemedicine.
Use of telemedicine should ensure and promote community integration and prevent isolation of the beneficiary. Evidence-based practice policies must be followed as appropriate for all services. For services within the community, in-person interactions must be prioritized.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2207, Apr. 1, 2025, (Accessed Apr. 2025).
For PIHP/CMHSP service providers, refer to the MDHHS Bureau of Specialty Behavioral Health Services Telemedicine Database and the Audio-Only Telemedicine Database on the MDHHS website for services allowed via both audio/visual and audio-only telemedicine.
This information should be used in conjunction with the Billing & Reimbursement for Professionals and the Billing & Reimbursement for Institutional Providers Chapters as well as the Medicaid Code and Rate Reference tool and other related procedure databases/fee schedules located on the MDHHS website.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2206, Apr. 1, 2025, (Accessed Apr. 2025).
Telemedicine is allowed for all services indicated in the Bureau of Specialty Behavioral Health Services Telemedicine Database. The features of what will be counted as a telemedicine visit need to align with the same standards of an in-person visit. Any phone call or web platform used to schedule, obtain basic information or miscellaneous work that would have been billed as a non-face-to-face and therefore non-billable contact, will remain non-billable. Telemedicine visits must include service provision as indicated in the IPOS and should reflect work towards or review of goals and objectives indicated forthwith.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2207, Apr. 1, 2025, (Accessed Apr. 2025).
Interprofessional Telephone/Internet/Electronic Health Record Consultations
Asynchronous telemedicine services include the transmission of a beneficiary’s medical or other personally identifiable information through a secure, HIPAA-compliant, electronic communications system to a provider, often a specialist, at a distant site without the beneficiary present. Such communications, including store and forward services, interprofessional telephone/Internet/electronic health record consultations, and remote patient monitoring (RPM) services, involve contact between two parties (beneficiary to provider or provider to provider) in a way that does not require real-time interaction. Services must be medically necessary or essential for behavioral health and part of a provider-directed treatment plan.
Providers should not report interprofessional telephone/Internet/electronic health record consultations when the sole purpose of the communication is to arrange a transfer of care or other face-to-face service
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2202, 2203, Apr. 1, 2025, (Accessed Apr. 2025).
Medication Therapy Management (MTM)
The following are not eligible to be covered as MTM services:
- Services provided by telephone, email or US Postal Service Mail.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 1865, Apr. 1, 2025, (Accessed Apr. 2025).
FQHCs and RHCs
Claims for telemedicine services must be submitted using the ASC X 12N 837 5010 form using the appropriate telemedicine HCPCS or CPT code. All telemedicine claims must include the corresponding modifier 95- “Synchronous Telemedicine Service rendered via a real-time interactive audio and video telecommunications system” or 93 – “Synchronous Telemedicine Service rendered via telephone or other real-time interactive audio-only telecommunications system” and the appropriate revenue code.
MDHHS will allow FQHCs and RHCs to be reimbursed for identified audio-only services (those represented on the audio-only database and that are identified as qualifying visits) to generate the PPS.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2211 & 2212, Apr. 1, 2025, (Accessed Apr. 2025).
Clinics will be permitted to submit for reimbursement allowable audio-only service codes, as indicated above, if appropriate for the interaction with the beneficiary. Medicaid clinic billing and reimbursement requirements apply. The provider must be employed by or contracted with the FQHC or RHC, and the procedure code billed must appear on the clinic reimbursement list as a qualifying visit. The clinic reimbursement list is located on the MDHHS website.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2212, Apr. 1, 2025, (Accessed Apr. 2025).
The Prepaid Inpatient Health Plan (PIHP) is responsible for managing Medicaid mental health services for all Medicaid beneficiaries residing within the service area covered by the PIHP. This includes the responsibility for timely screening, referral, and certification of requests for admission to PRTF services defined as follows:
- Screening means the PIHP and/or delegated CMHSP has been notified of the youth and has been provided enough information to support a referral to a PRTF based on the admission criteria established below. The screening may be provided on-site, face-to-face by PIHP and/or delegated CMHSP personnel, by telephone, or via a video conferencing platform.
- Certification means that the PIHP and/or delegated CMHSP has screened the youth and has documented that the services requested are appropriate. Telephone screening must be followed up by the written certification.
- All PRTF service authorizations will be made and entered into CHAMPS by MDHHS. The PIHP and/or delegated CMHSP should make referrals when appropriate and will be actively involved in treatment planning/monitoring meetings, discharge planning and transition to the community.
School Services Program
The 93 modifier is used with the appropriate procedure codes to identify when service is provided via telemedicine using audio only.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2044, Apr. 1, 2025, (Accessed Apr. 2025).
Maternal Infant Health Program
All audio-visual and audio-only MIHP telehealth services must be reported with:
- Modifier 93 for audio–only services
- Modifier 95 for audio-visual services
- Report the place of service (POS) code that would be reported as if the beneficiary were in-person for the visit (e.g., home or office)
Telehealth visits that occur via telephone-only are allowable only when a beneficiary barrier exists for use of an audio/visual platform (e.g., lack of smart phone or internet access). Documentation in the beneficiary’s chart must include the reason for a telephone-only visit.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 1181 Apr. 1, 2025; MI Dept. of Health and Human Services., Bulletin 24-57, Medicaid, Healthy Michigan Plan, Children’s Special Health Care Services, Children’s Waiver, Maternity Outpatient Medical Services, MI Choice Waiver, Nov. 27, 2024, (Accessed Apr. 2025).
Intensive Care Coordination with Wraparound (ICCW)
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 378, Apr. 1, 2025, (Accessed Apr. 2025).
Targeted Case Management Services for Children with Medical Complexity
Ongoing referral and service coordination activities include face-to-face, and/or reciprocal telephonic or written contacts with, or on behalf of, the beneficiary/parent/guardian.
Monitoring and follow-up activities include face-to face encounters, and/or reciprocal telephonic or written contact with, or on behalf of, the beneficiary/parent/guardian.
Referrals and service coordination services and monitoring and follow-up activities can include face-to face encounters, and/or reciprocal telephonic or written contact with, or on behalf of, the beneficiary/parent/guardian conducted by any member of the CMC TCM core team.
SOURCE: MI Dept. of Health and Human Services, Medicaid Provider Manual, p. 2189, Apr. 1, 2025, & MI Bulletin MMP 24-61, Targeted Case Management Services for Children with Medical Complexity, Dec. 23, 2024, (Accessed Apr. 2025).
Telemedicine is allowed for all services indicated in the Bureau of Specialty Behavioral Health Services Telemedicine Database. The features of what will be counted as a telemedicine visit need to align with the same standards of an in-person visit. Any phone call or web platform used to schedule, obtain basic information or miscellaneous work that would have been billed as a non-face-to-face and therefore non-billable contact, will remain non-billable. Telemedicine visits must include service provision as indicated in the IPOS and should reflect work towards or review of goals and objectives indicated forthwith.
Medicaid beneficiaries whose needs do not render them eligible for specialty services and supports through the PIHPs/CMHSPs may receive outpatient mental health services through Medicaid FFS or MHPs as applicable. These FFS/MHP enrolled non-physician behavioral health services may be provided via telemedicine when performed by Medicaid-enrolled psychologists, social workers, counselors, and marriage and family therapists. Services are covered when performed in a non-facility setting or outpatient hospital clinic. All applicable services are listed in the telemedicine audio/visual and audio-only fee schedules.