Michigan Medicaid covers qualifying community health worker services, but training alone does not establish payment eligibility. A worker needs the MI Medicaid CHW Registry and CHAMPS enrollment, with the correct billing relationship. This guide explains the current workforce process, important policy updates and the records Michigan program leaders should maintain. [1]
Michigan CHW quick facts
| Topic | Michigan guidance |
|---|---|
| Medicaid benefit | Implemented January 1, 2024. [1] |
| Workforce approval | MI Medicaid CHW Registry, followed by CHAMPS enrollment. [1,2] |
| Minimum eligibility | Age 18 and high school diploma or equivalent under the Medicaid framework. [3] |
| Training route | MDHHS-approved CHW training program. [4] |
| Old experience transition | Original temporary route required approved training by December 31, 2025. [4] |
| Rendering identifier | Individual Type 1 NPI; registry instructions describe rendering/servicing-only enrollment. [2] |
| Continuing education | At least six qualifying hours annually under MMP 23-74. [4] |
| Claim-note correction | C400, S400, P400 and T400 are not permitted. [5] |
| Clinic reimbursement | Eligible FQHC, RHC and THC CHW services are outside PPS or AIR. [6] |
| Training-provider applications | Current notice pauses new program approval activity through December 31, 2026. [2] |
| Last reviewed | November 6, 2026 |
For program leaders
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What does a CHW do in Michigan?
Michigan recognizes CHWs as community-connected workers who help people access health and social services. Medicaid's CHW framework addresses navigation, health promotion and education, and appropriate screening or assessment. The role depends on trust, cultural understanding and support for the participant's own goals. [1,4]
Employers should translate the role into a clear scope. Identify the community served, language needs, referral relationships and clinical escalation process. Community outreach may be valuable even when a particular contact does not qualify for reimbursement.
Is MiCHWA membership the same as Medicaid approval?
No. MiCHWA distinguishes its membership portal and professional development resources from the MI Medicaid CHW Registry. Registry approval verifies the workforce criteria used for the Medicaid benefit. CHAMPS is a further enrollment step. [2,3]
Track membership, course completion, registry status, NPI and CHAMPS status separately. An employee account in a software product is another separate item. None of those statuses should be inferred automatically from a worker having the title CHW.
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How do you qualify for the MI Medicaid CHW Registry?
MiCHWA's CHW information identifies age 18 and a high school diploma or equivalent among the Medicaid qualifications. Use the current registry instructions and approved training list to confirm the route and supporting documents for the individual applicant. [2,3]
The older work-experience transition should not be offered as a permanent training exemption. MMP 23-74 limited that initial route and required completion of approved training by December 31, 2025. Workers relying on older forms should ask the registry to resolve their current eligibility. [4]
Where can Michigan CHWs find approved training?
The registry page publishes an MDHHS-approved training list. Check the exact provider and program before enrollment. MiCHWA also describes its own competency-based training, including coursework and internship, and points to upcoming offerings. Provider-specific training length is not a single statewide course length. [2,7]
Compare current availability, tuition, delivery method, attendance and fieldwork. Ask what evidence the provider issues and whether it supports the Medicaid registry application. Specialty learning and behavioral health microcredentials can add skills without replacing the applicable core qualification.
Are applications for new training programs paused?
The current registry page announces a temporary pause in CHW training-program applications through December 31, 2026. It includes reviews, determinations, reconsiderations and resubmissions, with a stated goal of resuming January 1, 2027. [2]
This notice concerns approval of training programs. It should not be rewritten as a blanket shutdown of individual CHW registry applications or existing approved training. Organizations planning a new curriculum should confirm the timeline directly before advertising Medicaid-recognized status.
What is the registry application process?
The registry instructions tell applicants to obtain an individual Type 1 NPI, gather identifying and training information, complete the online application and submit verification documents. Follow the linked official process for sensitive application material. [2]
An employer can help a worker gather evidence and track outstanding items. Store only the information the employer actually needs, with appropriate access. Keep the application confirmation and approval decision separate from training completion.
How does CHAMPS fit into the process?
MDHHS says workers seeking Medicaid reimbursement need both the registry and enrollment in CHAMPS. Registry approval comes first. The agency's benefit hub links enrollment training and provider support for the applicable rendering and billing arrangement. [1,2]
Before the first payable service, verify the worker's effective enrollment, billing organization relationship and payer participation. A submitted application, an allocated NPI or an internal staff activation does not establish that enrollment is active for a date of service.
Which identity and enrollment record belongs to each step?
| Record | What it establishes |
|---|---|
| Course award | Completion of that training program |
| MI Medicaid CHW Registry | Verification of the Medicaid workforce criteria |
| Individual Type 1 NPI | The worker’s provider identifier |
| CHAMPS rendering/servicing enrollment | The enrolled worker and applicable effective dates |
| Associated billing provider | The Medicaid-enrolled organization or sole proprietor submitting the claim |
The foundational policy requires the worker to associate with at least one Medicaid-enrolled billing provider in CHAMPS. It permits an organizational Type 2 NPI or an individual sole proprietor’s Type 1 NPI for that billing role. Registry membership or an NPI allocation does not establish that the worker’s service-date enrollment and billing relationship are active. MMP 23-74, provider enrollment, page 6.
How much continuing education is needed?
MMP 23-74 requires at least six hours annually through an approved training program, aligned with core competencies, with evidence provided to the designated contractor. Follow the registry's current submission instructions. [4]
MiCHWA separately lists membership certification renewal conditions on its training page, including an annual fee and learning requirement. Do not describe that membership fee as a universal state Medicaid enrollment fee. Identify which program the worker is maintaining. [7]
Who can receive covered Michigan CHW services?
The foundational bulletin connects services with a health-risk or social-needs assessment and identifies circumstances such as a chronic health condition, an unmet health-related social need, or pregnancy and up to 12 months postpartum. A licensed healthcare provider must recommend the service. The recommendation, assessed need and CHW’s later service record are separate evidence. MMP 23-74, page 2.
For a fictional participant returning to care after a move, document the specific access barrier, recommendation source, agreed navigation work and response. A referral offered, an appointment requested and an appointment attended represent different outcomes. Do not infer a completed clinical visit from a successful navigation contact.
Which activities fall outside this CHW benefit?
The bulletin excludes services requiring a professional license, personal care, respite, beneficiary transportation, medication delivery and services already covered through peer-support programs. It also excludes non-health assistance enrollment outside the provider’s recommendation. A community program can value such work while distinguishing it from this particular payable CHW service. MMP 23-74, page 4.
Which Michigan Medicaid updates should program leads know?
The March 25, 2025 letter L 25-12 prohibits claim-note categories C400, S400, P400 and T400. It also requires a primary diagnosis and explains the role of permitted claim notes. Old templates should not continue presenting the removed categories as valid. [5]
Use an authorized clinical and billing process for diagnosis information. A CHW note or software suggestion should not invent a diagnosis to complete a claim. Maintain the source of the information and route unclear coding questions to the responsible professional.
How are CHW services handled in clinics?
The October 27, 2026 MDHHS alert reminds FQHCs, RHCs and Tribal Health Centers that eligible CHW services are paid outside the prospective payment system or all-inclusive rate at the applicable fee screen rate. The CHW's rendering NPI must be reported. [6]
Clinic teams should test the actual institutional billing instructions and rendering-provider field. Do not assume that the clinic's ordinary encounter payment includes the CHW service, or that listing only the clinic NPI satisfies the alert.
How do time, group size and other program payments affect billing?
MMP 23-74 specifies 15-minute units with modifier CG for its listed individual and group education/self-management codes, with no more than eight participants in a group. Its standard limits are two hours per day and 16 visits per month, up to 32 monthly hours per beneficiary. Exceeding the limit requires medical necessity and prior authorization. Confirm the current manual, fee screen and the participant’s plan before using these rules in a claim workflow. MMP 23-74, pages 6 to 7.
The bulletin also distinguishes separately payable work from services already included in Health Home or Certified Community Behavioral Health Clinic payments. For example, a CHW activity included in a CCBHC’s prospective payment cannot also be claimed as additional CHW reimbursement. Keep the actual funding arrangement with the encounter review instead of assuming a second job title creates a second payable service. MMP 23-74, page 8.
Are CHW services the same as peer support services?
No. MMP 24-29 clarifies coverage through specialty behavioral health providers effective October 1, 2024 while distinguishing CHW services from separately covered peer support and peer recovery coaching. CHW qualifications still apply when billing CHW services. [8]
A worker may have several roles or credentials. Identify which service was actually delivered, the applicable qualification and the funding arrangement. Avoid billing the same work twice under different titles.
What should Michigan CHW documentation show?
The foundational policy calls for the service date, start and end times, description of professional services and source of the licensed provider's recommendation. Use current Medicaid and plan instructions when creating a template. [4]
For operational follow-up, also make the participant's goal, response, referral outcome and next owner easy to find. Distinguish navigation from actually transporting someone, and planned support from a completed service. Keep corrections visible.
What should Michigan CHW software demonstrate?
Test workforce status and service work together. Start with a worker whose registry is approved but CHAMPS enrollment is pending. Then use an active worker to document a fictional service, preserve recommendation evidence and track an unresolved referral.
Explore community health workflows with Smores Health using your actual documentation and reporting checklist. Ask which steps are supported today, which require configuration and which remain outside the product. Medicaid claims submission is not live in Smores Health.
See it in your program
Build your program around a connected workflow.
Bring your forms and reporting needs. See how Smores Health connects service notes, supervisor review, and program reporting in a walkthrough focused on your team.
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What should directors measure before expanding a program?
Separate registry-ready workers, enrollment-ready workers, participants served, contacts and referral outcomes. Add payer-specific financial measures only after the underlying service and enrollment rules are established.
Review one report from the total down to its records. Test a corrected note, changed enrollment date and participant receiving several services. A credible expansion plan needs reproducible workload and outcome evidence, rather than assuming every contact becomes a paid claim.
Frequently asked questions
Is MiCHWA membership enough for Medicaid reimbursement?
No. The Medicaid registry and CHAMPS enrollment are separate requirements. [1,3]
Is the original experience route a permanent exemption?
The foundational bulletin required approved training by the end of 2025 for that temporary transition. Confirm current status with the registry. [4]
Does the training-program pause stop all individual applications?
The notice addresses approval activity for training programs. Individual applicants should follow the separate registry process. [2]
Can a clinic omit the CHW rendering NPI?
The October 2026 alert says the CHW must be reported as rendering provider and warns that omission can cause denial. [6]
What should a Michigan CHW software demo include?
Ask for registry and enrollment status, a time-supported service note, referral follow-up and a report that can be traced to source records.
Build a more dependable Michigan CHW workflow
Bring a workforce checklist, a blank encounter form and one report to Smores Health. Book a program walkthrough to evaluate your Michigan program's documentation and follow-up needs. Request pricing for a defined implementation scope.
Sources
[1] MDHHS, community health worker benefit hub. https://www.michigan.gov/mdhhs/assistance-programs/medicaid/community-health-workers
[2] MiCHWA, MI Medicaid CHW Registry. https://michwa.org/mi-medicaid-chw-credential-registry/
[3] MiCHWA, CHW qualification and registry questions. https://michwa.org/for-chws/
[4] MDHHS, foundational bulletin MMP 23-74. https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Assistance-Programs/Medicaid-BPHASA/2023-Bulletins/Final-Bulletin-MMP-23-74-CHW.pdf
[5] MDHHS, claim clarification L 25-12, March 25, 2025. https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Assistance-Programs/Medicaid-BPHASA/2025-L-Letters/Numbered-Letter-L-25-12-CHW.pdf?hash=6F4A2071FD6A1BAEC6AB50F14391AB22&rev=6f1956cfc2ed4838bd2e357e7475438e
[6] MDHHS, clinic billing alert, October 27, 2026. https://www.michigan.gov/mdhhs/assistance-programs/medicaid/portalhome/medicaid-providers/medicaid-provider-alerts/all-alerts-and-updates/october-27-2026-community-health-worker-codes-in-a-clinic
[7] MiCHWA, training and continuing education. https://michwa.org/training/
[8] MDHHS, specialty behavioral health update MMP 24-29. https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Assistance-Programs/Medicaid-BPHASA/2023-Bulletins/Final-Bulletin-MMP-24-29-CHW.pdf?hash=E433EBB45284B63AF4C9F879EED559FF&rev=8442dda3aea84ecda046f323b2afac91