MedicaidPrior AuthMedium impact
MMP 25-51: Coverage Changes to Intermittent Urinary Catheters
Michigan Medicaid - MDHHS·MI · Urology, Family Medicine, Internal Medicine +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Starting January 1, 2026, hydrophilic-coated intermittent catheters will no longer require prior authorization for Michigan Medicaid patients, but providers must now document medical necessity for coude tips, hydrophilic coatings, and sterile insertion kits. The policy also removes specific coverage criteria for hydrophilic catheters previously limited to certain conditions.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflows to remove PA requirements for hydrophilic-coated intermittent catheters when standard coverage criteria are met. Providers must document medical necessity for coude tips, hydrophilic coatings, and sterile kits in patient files. Update documentation templates to capture required justifications. Monitor for new HCPCS codes specific to hydrophilic catheters that will be issued by CMS in 2026.