MedicaidAdministrativeMedium impact
MMP 25-01: Clarification of Enrollment Requirement for Prescribers
Michigan Medicaid - MDHHS·MI · Pharmacy·Enrollment
Effective date
Feb 15, 2025
We identified it
Jun 20, 2026
Summary
Michigan Medicaid is restricting the use of emergency override code SCC 13 for non-enrolled prescribers, effective February 15, 2025. Pharmacies can only use this override in specific emergency circumstances defined by federal guidelines, while SCC 55 continues to be allowed for validated prescriber enrollment.
Action Required
By February 15, 2025: Billing team must ensure all prescribing providers are enrolled in Michigan CHAMPS system to avoid pharmacy claim denials. Review current prescriber roster and verify enrollment status. Coordinate with pharmacies to understand when they can use emergency override SCC 13 versus SCC 55. Claims will be denied with NCPDP Code 889 if prescribers are not enrolled and emergency criteria are not met.