MedicaidBilling CodesHigh impact
MMP 25-06: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
Michigan Medicaid - MDHHS·MI·Claims & Billing
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Michigan Medicaid is implementing extensive CPT and HCPCS code changes effective January 1, 2025, including new covered codes, discontinued codes, and changes to audio-only telemedicine billing requirements. Providers must update billing systems to accommodate new codes while removing discontinued ones.
Action Required
By January 1, 2025: Billing team must update billing system to activate new covered codes (25448, 38228, 49186-49190, etc.) and deactivate discontinued codes (15819, 21632, 33471, etc.). For audio-only telemedicine, replace CPT codes 99441-99443 with appropriate E/M codes using modifier 93. Update encounter forms and billing software to reflect new code coverage by provider type. Verify prior authorization requirements for codes marked with asterisk (J1307, J1414, J3392, E1800-E1815, L5647). Failure to update will result in claim denials for new codes and rejection of discontinued codes.