MedicaidReimbursementLow impact
MMP 25-54: Reimbursement to Hospitals Outside Michigan
Michigan Medicaid - MDHHS·MI · Pediatrics·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 20, 2026
Summary
Michigan Medicaid now reimburses children's hospitals in states bordering Michigan's upper peninsula at 150% of the base DRG rate for inpatient services. This enhanced rate applies to hospitals with Children's Hospital subspecialty enrollment for discharges on or after October 1, 2025.
Action Required
No immediate action required for most practices. If your practice refers pediatric patients to children's hospitals in Wisconsin or Minnesota near Michigan's upper peninsula, be aware that these facilities now receive enhanced Medicaid reimbursement at 150% of base DRG rates, which may improve access to care.