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Primary Care Provider Incentive Payment Program

Pursuant to Section 1801 of Public Act 107 of 2017, MDHHS provides an increased payment rate for Medicaid primary care services rendered by qualified primary care providers.  The increased payment rate is applicable to a specific set of primary care services delivered by Medicaid enrolled qualified providers with the specialty designation of:  

  • family medicine
  • general internal medicine
  • pediatric medicine; or
  • general medicine.

Requirements related to the increased payments apply to services reimbursed by Medicaid Fee-For-Service and Medicaid Health Plans. 

Primary care providers are required to self-attest by designating their primary specialty in their CHAMPS provider enrollment profile as one of the four eligible specialties and provide applicable Board certification information.  Providers may verify eligibility by logging into their CHAMPS accounts.

Below is guidance and historical resource documents for Medicaid Health Plans and physicians that provide additional information for this program.

Resource Documents

Policy: MSA 14-61, MSA 17-43

Letters: L 13-55, L 13-67L 14-34

Final Rule - 42 CFR Part 438, 441, and 447