Behavioral healthcare leaders across Michigan and the broader Great Lakes region are navigating a shifting policy environment that will shape access, reimbursement, and compliance for years to come. For clients and families, these changes can feel distant, but they directly affect practical questions like: Can I keep seeing my therapist by telehealth? Will my insurance pay the same for virtual care? Will I have more options to find the right clinician?

Since River’s Bend provides evidence-based outpatient behavioral health treatment for mental health and substance use disorders, and we’re closely tracking the regulatory reforms that could materially impact how behavioral health services are delivered, both in-person and via telehealth.

The three policy timelines to watch (and why they matter)

If you only take away three dates, make it these:

1) December 31, 2026: Federal telehealth rules for controlled-substance prescribing may change¹

If a care plan involves certain controlled medications (often managed through psychiatry), federal flexibilities allowing some prescribing via telehealth without an in-person exam are scheduled to sunset after 12/31/2026.

Why it matters for behavioral healthcare: this could affect how quickly some patients can begin or maintain certain medication regimens through telehealth—especially in areas facing provider shortages.

Callout: Want help planning around this?
If your organization, referral network, or care pathway includes psychiatric medication management, contact River’s Bend to discuss continuity-of-care planning, access strategy, and compliant care coordination.

2) December 31, 2027: Medicare telehealth flexibilities are scheduled through this date²

Current Medicare telehealth extensions run through 12/31/2027, with broader reversion changes beginning 1/1/2028.

Why it matters for Michigan behavioral health providers: while behavioral health telehealth is generally more protected than other medical telehealth, operational requirements increase in 2028 (more on that below). Leaders should treat late 2027 as the planning horizon for workflow redesign and compliance readiness.

3) 2026 Michigan legislative session: Telehealth payment parity (SB 772) is pending³

Michigan Senate Bill 772 (introduced 1/28/2026) would require insurers to cover telemedicine at the same rate as in-person services for the same care.

Why it matters for outpatient behavioral health in Michigan: if enacted, parity could reduce payer-by-payer rate variability and improve reimbursement predictability for services like therapy, substance use disorder treatment, and other outpatient behavioral healthcare delivered via telehealth.

Callout: If parity becomes law, it could also attract new market entrants—changing competition in Grand Rapids, West Michigan, and statewide.

Medicare telehealth in 2028: not a shutdown, but a new set of requirements

Behavioral health telehealth is relatively stable, yet still faces meaningful operational change

Starting in 2028, Medicare rules are expected to tighten for many non-behavioral telehealth services. Behavioral health is comparatively more stable, but Medicare’s behavioral telehealth requirements may add administrative steps that affect access if a provider isn’t prepared.

The “in-person visit” requirement is the biggest operational shift

The Medicare behavioral telehealth requirement for an in-person visit within six months of initiating telehealth (and periodic visits after that) is delayed until after 12/31/2027⁴, meaning it could take effect 1/1/2028 at the earliest.

In plain language for clients and families:
Telehealth can remain an excellent option, but some Medicare-covered patients may need occasional in-person visits to keep telehealth covered.

For industry leaders:
This becomes a workflow issue—tracking due dates, creating scheduling capacity, and preventing interrupted care.

How River’s Bend can help:
River’s Bend partners with clients, families, and professional referral sources to support care continuity, access to treatment, and strong clinical engagement, whether services are delivered virtually or in-person. Contact River’s Bend to learn more about outpatient program options and how we support treatment planning.

Audio-only (phone) sessions: still possible, but documentation matters more

Audio-only behavioral telehealth remains available through 12/31/2027⁵. Beginning in 2028, Medicare is expected to allow audio-only behavioral health visits at home when:

• the clinician is capable of video, and
• the patient can’t use video or does not consent to video

Why this matters in Michigan communities:
Audio-only visits can support access when broadband is limited, technology is unreliable, or privacy concerns make video difficult.

What’s changing isn’t necessarily access it’s compliance expectations. Providers who use audio-only as an access tool should standardize documentation to reflect the required rationale.

Callout: A small documentation improvement can reduce audit risk while protecting equitable access to behavioral healthcare.

Controlled-substance telehealth prescribing: planning for the 2026 shift

Federal DEA/HHS telemedicine flexibilities that allow certain controlled-substance prescribing via telehealth are extended through 12/31/2026.

Why leaders care:
If rules tighten, demand for in-person evaluation appointments could increase quickly, especially for psychiatry-related services.

What clients should know:
If your treatment includes medication, a provider may recommend an in-person appointment at certain points—not as a barrier, but because regulations may require it.

Need help thinking through access and continuity?
River’s Bend supports comprehensive outpatient treatment for mental health and substance use disorders and can help families and partners understand care options and continuity planning. 

Michigan telehealth payment parity (SB 772): why it could be a big deal for behavioral health

If Michigan SB 772 passes, it could:

• Improve reimbursement predictability for telehealth behavioral health services
• Reduce rate variation across insurers for the same service
• Encourage investment in virtual access and clinical capacity
• Potentially increase competition as more providers enter telehealth markets⁶

What this could mean for Southeast Michigan clients:
More predictable reimbursement can support broader availability of telehealth appointments, often translating to improved access, shorter waits, and stronger continuity of care.

Licensure compacts: one of the biggest “access levers” for the Great Lakes region

Most states require clinicians to be licensed where the patient is located during the visit. Interstate licensure compacts can help eligible clinicians work across state lines with fewer administrative barriers.

Where Michigan is already positioned well: PSYPACT for psychologists

Michigan is already part of PSYPACT, supporting interstate telepsychology (within compact rules). That can expand recruiting options and access, particularly valuable in areas with high demand.⁷

What’s next: Counseling and Social Work compacts

Compacts involving counselors and social workers are especially relevant to outpatient behavioral healthcare workforce capacity. If Michigan joins and operationalizes these compacts, the likely impacts include:

• Easier recruitment across the Midwest
• More cross-border telehealth options
• Increased competition from out-of-state providers serving Michigan patients

Why this matters for behavioral health leaders:
Compacts can expand access, but they also change the competitive landscape quickly.

Contact River’s Bend to learn more

Whether you’re an industry partner planning networks and step-down pathways, or a client/family exploring treatment options, River’s Bend can help you understand what’s changing and how to stay connected to care.

Contact River’s Bend to learn more about:

• outpatient behavioral health treatment in Michigan
• evidence-based mental health treatment
• substance use disorder treatment
• telehealth and in-person care options
• support for clients and families across West Michigan and beyond

References

1. Fourth temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications. (2025, December 31). Federal Register. https://www.federalregister.gov/documents/2025/12/31/2025-24123/fourth-temporary-extension-of-covid-19-telemedicine-flexibilities-for-prescription-of-controlled  ↩︎
2. Telehealth FAQ. (2026). https://www.cms.gov/files/document/telehealth-faq-updated-02-04-2026.pdf  ↩︎
3. Senate Bill 772 of 2026 – Michigan Legislature. (n.d.). https://www.legislature.mi.gov/Bills/Bill?ObjectName=2026-SB-0772  ↩︎
4. Mshepard. (2026, February 5). Medicare Telehealth coverage extended through 2027. Center for Medicare Advocacy. https://medicareadvocacy.org/medicare-telehealth-coverage-extended-through-2027/  ↩︎
5. Telehealth. (n.d.). Medicare. https://www.medicare.gov/coverage/telehealth  ↩︎
6. MI – SB0772. (n.d.). BillTrack50. https://www.billtrack50.com/billdetail/1951161  ↩︎
7. Psychology Interjurisdictional Compact (PSYPACT). (2023). Psychology Interjurisdictional Compact (PSYPACT) Frequently Asked Questions (FAQs). In Psychology Interjurisdictional Compact (PSYPACT) Frequently Asked Questions (FAQs). https://www.michigan.gov/lara/-/media/Project/Websites/lara/bpl/Psychology/Licensing-Info-and-Forms/Psychology-Interjurisdictional-Compact-PSYPACT-Information.pdf  ↩︎