Mental Health & Substance Use Disorder Reporting Requirements
- COVID-19 Encounter Code Chart
In order to monitor service provision, expenditures and consumer outcomes, the Department requires Community Mental Health Services Providers (CMHSPs), and Pre-Paid Inpatient Health Plans (PIHPs) to provide information and data on topics such as costs, services, consumer demographics, and administrative activities. The following is a list of key instructional documents for reporting to the federal Substance Abuse and Mental Health Services Administration.
(Click here for data reports and statistics.)- Link to Core HIPAA-Related Health Plan Materials
- SFY 2022 Behavioral Health Code Charts and Provider Qualifications (Updated 12/03/21)
- BHDDA Telemedicine Database (11/4/2021)
- Michigan Fidelity Assistance Support Team (MIFAST)
- Prepaid Inpatient Health Plan Accreditation Status
Administrative Cost Reporting - Forms and Instructions
Administrative Cost Reporting Fiscal Year 2019
Forms and Instructions Revised and Posted for FY19 Expenditures per FY19 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/28/2020)
Revised Due Date: 03/13/2020Administrative Cost Reporting Fiscal Year 2018
Forms and Instructions Revised and Posted for FY18 Expenditures per FY18 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/14/2019)Administrative Cost Reporting Fiscal Year 2017
Forms and Instructions Revised and Posted for FY 17 Expenditures per FY17 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/10/2018)Administrative Cost Reporting Fiscal Year 2016
Forms and Instructions Revised and Posted for FY 16 Expenditures per FY16 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/10/2017)-
Previous Years 2009 - 2015
Medical Loss Ratio Reporting - Forms and Instructions
Medical Loss Ratio Reporting State Fiscal Year 2020
Forms and Instructions Posted for FY20 Expenditures per FY20 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/17/2021)
Due date: 03/31/2021- Medical Loss Ratio Reporting Template (.xlsx)
- Medical Loss Ratio Reporting Instructions (.pdf)
- Medical Loss Ratio and EQI Reconciliation (.pdf)
Medical Loss Ratio Reporting State Fiscal Year 2019
Forms and Instructions Posted for FY19 Expenditures per FY19 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/28/2020)
Revised due date: 06/15/2020Medical Loss Ratio Reporting State Fiscal Year 2018
Forms and Instructions Posted for FY18 Expenditures per FY18 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/14/2019)
Annual Submission Requirement - Forms and Instructions
Annual Submission Requirement Instructions (Last Updated 1/27/2021)
Submission Due Date: March 31, 2021
- FY20 Annual Submission Instructions
- Needs Assessment Guidelines
- FY20 Attachment A Waiting List
- FY20 Attachment B Request for Service and Disposition of Requests
- FY20 Attachment C Community Data Sets Instructions
- FY20 Attachment C Community Data Set Worksheet
- FY20 Attachment E COVID-19 Priority Needs and Planned Actions
Financial Status Reporting
Financial Status Reporting Fiscal Year 2021
Contract Requirements Per General Fund Section P6.5.1.1 and PIHP contract Schedule E
Financial Status Reporting Fiscal Year 2020
Contract Requirements Per General Fund Section P6.5.1.1 and Medicaid Section P7.7.1.1Financial Status Reporting Fiscal Year 2019
Contract Requirements Per General Fund Section P6.5.1.1 and Medicaid Section P7.7.1.1
(Medicaid contract amendment #3)Financial Status Reporting Fiscal Year 2018
Contract Requirements Per General Fund Section P6.5.1.1 and Medicaid Section P7.7.1.1
(Medicaid contract amendment #2 effective 6/1/2018)Financial Status Reporting Fiscal Year 2017
Contract Requirements Per General Fund Section P6.5.1.1 and Medicaid Section P7.7.1.1
Last updated 12/01/2017Financial Status Reporting Fiscal Year 2016
Contract Requirements Per General Fund Section P6.5.5.1 and Medicaid Section P7.7.1.1
Last updated 5/11/2016-
Previous Years FY2009 - FY2015
SUD (Non-Medicaid) Reporting - Forms and Instructions
PIHP SUD Reporting for FY 2022
Contract Requirements Per PIHP Contract Schedule E
- Reporting Index V-2022 - Forms and Instructions
PIHP SUD Reporting for FY 2021
Contract Requirements Per PIHP Contract Schedule E
- Reporting Index V-2021 - Forms and Instructions
PIHP SUD Reporting for FY 2020
Contract Requirements Per Medicaid Section 7.7.1.1
- Reporting Index V-2020 - Forms and Instructions
PIHP SUD Reporting for FY 2019
Contract Requirements Per Medicaid Section 7.7.1.1
- Reporting Index V-2019 - Forms and Instructions
- PIHP SUD Reporting Archive
Performance Bonus Incentive
- Performance Bonus Joint MHP/PIHP Metrics
- PIHP-only Pay for Performance Measures
BH - TEDS
- BH-TEDS FY22 Admission & Discharge Extract Formats
- BH-TEDS FY22 File Specifications
Effective 10/01/2021 - Rev 09/28/2021
- Field Requirements - Color Coded
Rev. 08/12/2021
- BH-TEDS FY22 Error Descriptions
Effective 10/01/2021 - Rev 09/29/2021
- BH-TEDS FY21 File Specifications
Effective 10/01/20 - Rev. 06/10/21
- BH-TEDS FY21 Error Descriptions
Effective 10/01/20 – Rev 09/23/20
- BH-TEDS Coding Instructions FY22
Rev. 09/28/2021
- BH-TEDS Q & A
Rev. 9/16
- BH-TEDS Error Logic
- FY19 Q Record Error Description
Rev. 08/01/2019
Please send all questions and comments to Carol Hyso at HysoC@michigan.gov.
BH - REGISTRY FILE
- BH - Registry File Process Documentation
Please send all questions and comments to Dick Berry at BerryR3@michigan.gov.
CMHSP/PIHP MDHHS Systems List
- CMHSP/PIHP MDHHS Systems List
Many data systems are required in order to satisfy MDHHS reporting requirements. The "CMHSP/PIHP MDHHS Systems List" identifies how to add, change, or inactivate user accounts for systems that BHDDA requires the CMHSPs and PIHPs to use for reporting.
If you have questions or comments, contact Jackie Sproat at sproatj@michigan.gov.
Instructions for Reporting Financial Information - 837 Encounters
- LARA License Reporting
- Instructions for Reporting Financial Information (Updated: 04/22/2013)
Documentation on how to report financial information via the 837 including charged and paid amount, and provider identification.
PIHP and CMHSP Cost Reporting Forms
- Encounter Quality Initiative - SFY2021 Behavioral Health Templates
- Encounter Quality Initiative - SFY2020 Behavioral Health Templates
Reporting Instructions for Specialty Services and HMP
Due Date Friday, March 13, 2020, 5:00 pm
Reporting Instructions for Specialty Services and HMP
Due Date Friday, January 31, 2020, 5:00 p.m.
Reporting Instructions for Specialty Services and HMP
Due Date Monday, September 2, 2019, 5:00 p.m.
CMHSP FY19 Sub-Element Cost Reporting Form and Reporting Instructions (1/21/2020)
Template for CMHSP FY19 Cost Reporting (Oct 2018-Sept. 2019)
Due Date March 13, 2020 5:00 p.m.CMHSP FY19 General Fund Cost Reporting Form and Reporting Instructions (12/27/2019)
Template for CMHSP FY19 General Fund Cost Reporting (Oct. 2018 - Sept. 2019)
Due Date March 13, 2020 5:00 p.m.CMHSP FY18 Sub-Element Cost Reporting Form and Reporting Instructions
(Updated: 01/03/2019)Template for CMHSP FY18 Cost Reporting. (Oct 2017-Sept 2018)
Due date February 28, 2019 5:00 P.M.CMHSP FY18 General Fund Cost Reporting Form and Reporting Instructions (Updated: 01/03/2019)
Template for CMHSP FY18 General Fund Cost Reporting (Oct 2017-Sept 2018).
Due date February 28, 2019 5:00 P.M.
Policy 2077 Documents
Standard Cost Allocation Methodology
- Draft Standard Cost Allocation Model 20210901
- Draft Standard Cost Allocation Model 20210901 w Example Data
- CMHSP Standard Cost Allocation Model Instructions
- PIHP-CMHSP Standard Cost Methodology - Revised Draft for Discussion Purposes Only
- Appendix 1 and 2
- Instructions for Provider Service Expense Survey
- BH Provider Service Expense Survey
PIHP and CMHSP Performance Indicator Systems
Michigan's Mission-Based Performance Indicator System (Updated: 2/21/2020)
Detailed instructions for reporting the Performance Indicators. Includes codebooks. Required for PIHPs and CMHSPs.
CMHSP Template (Updated: 06/01/2020)
PIHP Template (Updated: 06/01/2020)
- Materials for Performance Indicator Follow-up Webinar
Network Adequacy Standards
Encounter Data Integrity Team (EDIT)
- Proposed Services Codes for FY22, effective October 1, 2021
- SFY 2022 Behavioral Health Code Charts and Provider Qualifications (Updated 12/03/21)
- SFY 2022 EQI and Full Code Modifier Behavioral Health Code Sets
- SFY 2022 BHDDA Code Sets Technical Assistance
- Technical Assistance Question and Answers (Updated 11/22/21)
FY2021 Code Chart and Provider Qualifications
- 2020 EDIT OTP Dual Eligibles Subgroup
- 2020/21 H2015 Subgroup
- 2021 Modifier Changes FY22 Subgroup
- Encounter Data Integrity Team (EDIT)
Other Resources
-
Behavioral Health Home Cost Efficiency Studies (05-14-2020)
- Instructions for Generating a CAFAS® and PECFAS® Aggregate Reports (Updated: October 2020)
Instructions for generating aggregate annual Child and Adolescent Functional Assessment Scale (CAFAS) and Pre-School and Early Childhood Functional Assessment Scale (PECFAS) reports.
- MDCH/PIHP Event Reporting FY11 (Updated: 11/01/2010)
Documentation on how to report to the Event Reporting System. Includes requirements, coding instructions, technical specification and the Implementation Guide. Current reporting includes suicides, non-suicide deaths, emergency medical treatment due to injury or medication error, hospitalizations due to emergency or medication error, and arrests for reportable populations .
- NPI Reporting Guidelines for 837 Encounter Transactions (Updated: 06/10/2016)
Includes all reportable HCPCS and Revenue codes for mental health. Contains updated instructions on use of modifiers and the acceptable activities that may be reflected in the cost of each procedure such as whether an activity needs to be face-to-face.
- Private Duty Nursing Authorizations Manual (Updated: 08/25/2010)
The User Manual guides CMH staff who are authorized through CHAMPS to enter prior authorizations for private duty nursing.
If you have questions on this material, please e-mail Kathy Haines at HainesK@michigan.gov.
