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MMP 25-26: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
Act
by Jul 1, 2025
Effective date
Jul 1, 2025
Identified
Jun 20, 2026
Summary
Michigan Medicaid has updated CPT and HCPCS codes effective July 1, 2025, adding new covered codes for various provider types and discontinuing several existing codes. This affects billing for Medicaid, Healthy Michigan Plan, and related programs in Michigan.
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What to do
by Jul 1, 2025 · 4 steps
01Billing team must update billing system to add new covered HCPCS codes (J0165, J0167, J0168, J0169, etc.) based on provider type and remove discontinued codes (Q2034-Q2039, J0171, J0173, etc.) from active billing lists.
02Set up prior authorization requirements for codes marked with asterisk (J3391, Q2058).
03Verify provider-specific code allowances match practice type.
04Claims using discontinued codes after June 30, 2025 will be denied.
Codes mentioned
J0165J0167J0168J0169J0616J0618J1163J1326J2312J2313J3373J3374J3375J3391J7172J7356J9220J9276J9289J9341J9342Q2058Q5099Q5100L1851L1852Q2034Q2035Q2036Q2037Q2038Q2039C9173C9300C9301C9302C9303C9304G9037G9038J0171J0173J2310J2311J3370J3371J3372J9340M0248
Original notice
MMP 25-26: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
michigan.gov · Always check the source before changing claims.
Related changes
See all Michigan Medicaid - MDHHS changes →MMP 23-08: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesMediumEffective Jan 1, 2023 · Claims & BillingMMP 24-25: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2024 · Claims & BillingMMP 24-50: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Oct 1, 2024 · Claims & BillingMSA 21-35MediumNo effective date · Provider BulletinBrowse every Michigan Medicaid - MDHHS change in the policy list
Related policy hubs
Michigan Medicaid - MDHHS policiesMI policy changesCode J0165Code J0167Code J0168Code J0169Code J0616Code J0618Code J1163Code J1326Code J2312Code J2313Code J3373Code J3374Code J3375Code J3391Code J7172Code J7356Code J9220Code J9276Code J9289Code J9341Code J9342Code Q2058Code Q5099Code Q5100Code L1851Code L1852Code Q2034Code Q2035Code Q2036Code Q2037Code Q2038Code Q2039Code C9173Code C9300Code C9301Code C9302Code C9303Code C9304Code G9037Code G9038Code J0171Code J0173Code J2310Code J2311Code J3370Code J3371Code J3372Code J9340Code M0248