MedicaidPrior AuthMedium impact
MMP 25-02: Emergency Services Only Ventilator Services
Michigan Medicaid - MDHHS·MI · Critical Care, Emergency Medicine, Pulmonology·Provider Bulletin
Effective date
Mar 1, 2025
We identified it
Jun 20, 2026
Summary
Michigan Medicaid now covers ventilator services for Emergency Services Only (ESO) beneficiaries when medically necessary to treat emergency conditions. All ventilator services for ESO patients require prior authorization from MDHHS Program Review Division on a case-by-case basis.
Action Required
Before March 1, 2025: Billing team must update prior authorization workflows to require MDHHS Program Review Division approval for all ventilator services provided to ESO Medicaid beneficiaries. Train staff to identify ESO patients and submit medical necessity documentation. Providers must report to PRD when ESO patients are weaned off ventilator and stable for 14 days during authorization period.