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Michigan Medicaid - MDHHSMedicaid · Prior Auth · Provider Bulletin · MI · PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational TherapyMedium impact

MMP 24-58: Complex Rehabilitation Technology (CRT) Equipment

Effective date
Jan 1, 2025
Identified
Jun 20, 2026

Summary

Effective January 1, 2025, Michigan Medicaid limits providing complex rehabilitation technology (CRT) equipment and accessories, including repairs to and replacement of CRT equipment, to DME providers enrolled with Medicaid as CRT providers, and CRT HCPCS codes cannot be included in competitive bidding. All CRT base equipment and CRT-specific accessories listed in Attachment A require prior authorization. Non-CRT DME providers may supply CRT equipment only case by case through prior authorization when no enrolled CRT provider is available in the beneficiary's geographic location.

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What to do

Action · 6 steps
01Already effective January 1, 2025 check current applicability in the current Medicaid Provider Manual before acting on these items.
02Only DME providers enrolled with Medicaid as CRT providers may supply CRT equipment and accessories, unless MDHHS approved a non-CRT DME provider through prior authorization; billing team should confirm the supplier's enrollment before billing.
03Billing team must obtain prior authorization for all CRT base equipment and CRT-specific accessories listed in Attachment A, and for Medicaid health plan enrollees must check the beneficiary's MHP for its prior authorization requirements.
04For repairs to CRT base equipment delivered Previously due January 1, 2025 (date passed; verify current applicability), the non-CRT DME provider that delivered the original equipment must include the original PA number and the make, brand, model and serial number in the future PA request, or, where PA is not required for the part, in the claim notes on direct data entry claims or in loop 2300 NTE on the 837P claim.
05DME providers enrolling as CRT providers must add the complex rehabilitation technology subspecialty in CHAMPS Provider Enrollment for each accredited location, ending any existing no subspecialty entry first, before submitting PA requests for CRT equipment or accessories.
06CRT equipment requires evaluation by a qualified health care professional with a qualified CRT professional present at the time of the evaluation.

Codes mentioned

E0637E0638E0641E0642E1161E1228E1229E1231E1232E1233E1234E1235E1236E1237E1238E8000E8001E8002K0005K0835K0836K0837K0838K0839K0840K0841K0842K0843K0848K0849K0850K0851K0852K0853K0854K0855K0856K0857K0858K0859K0860K0861K0862K0863K0864K0868K0869K0870K0871K0877K0878K0879K0880K0884K0885K0886K0890K0891K0898E0986E1002E1003E1004E1005E1006E1007E1008E1009E1010E1012E1014E2298E2301E2310E2311E2312E2313E2321E2323E2324E2325E2326E2327E2328E2329E2330E2331E2351E2373E2374E2376E2377E2609E2617K0040

Original notice

MMP 24-58: Complex Rehabilitation Technology (CRT) Equipment
michigan.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Michigan Medicaid - MDHHS changes →
MSA 18-17MediumEffective Jul 1, 2018 · Provider BulletinMMP 25-14: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Apr 1, 2025 · Claims & BillingMMP 24-15: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesMediumEffective Apr 1, 2024 · Claims & BillingBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesPM&R (Physical Medicine & Rehab)Physical TherapyOccupational TherapyCode E0637Code E0638Code E0641Code E0642Code E1161Code E1228Code E1229Code E1231Code E1232Code E1233Code E1234Code E1235Code E1236Code E1237Code E1238Code E8000Code E8001Code E8002Code K0005Code K0835Code K0836Code K0837Code K0838Code K0839Code K0840Code K0841Code K0842Code K0843Code K0848Code K0849Code K0850Code K0851Code K0852Code K0853Code K0854Code K0855Code K0856Code K0857Code K0858Code K0859Code K0860Code K0861Code K0862Code K0863Code K0864Code K0868Code K0869Code K0870Code K0871Code K0877Code K0878Code K0879Code K0880Code K0884Code K0885Code K0886Code K0890Code K0891Code K0898Code E0986Code E1002Code E1003Code E1004Code E1005Code E1006Code E1007Code E1008Code E1009Code E1010Code E1012Code E1014Code E2298Code E2301Code E2310Code E2311Code E2312Code E2313Code E2321Code E2323Code E2324Code E2325Code E2326Code E2327Code E2328Code E2329Code E2330Code E2331Code E2351Code E2373Code E2374Code E2376Code E2377Code E2609Code E2617Code K0040

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