MedicaidBilling CodesMedium impact
MMP 25-46: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
Michigan Medicaid - MDHHS·MI·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has updated CPT and HCPCS code coverage effective October 1, 2025, adding new covered codes for various provider types and discontinuing several codes as of September 30, 2025. The policy also provides retroactive coverage for some existing codes dating back to June 2025.
Action Required
By October 1, 2025: Billing team must update billing software to include newly covered HCPCS codes for Michigan Medicaid patients based on provider type. Remove discontinued codes (0450U, 0451U, C9088, C9174, C9175, C9248, J2150, J2503, S0074) from system as they are no longer covered as of September 30, 2025. Configure prior authorization requirements for codes J3403, J7173, J7174, and Q5151. Submit retroactive claims for eligible services using newly covered codes dating back to June-August 2025.