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MMP 24-50: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Michigan Medicaid - MDHHS·MI·Claims & Billing
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid has implemented multiple HCPCS/CPT code updates with various effective dates, including new drug codes (J-codes), discontinued codes, and retroactive coverage for vaccines and other services. Most changes took effect October 1, 2024, but some have retroactive coverage back to January 2024.

Action Required

Action needed
Immediately: Update billing system to include new covered codes (J0138, J1171, J2002, J2003, J2004, J2252, J2601, J9329, Q5135, L1006, L1653, L1821, J9325, S0013) effective October 1, 2024. Remove discontinued codes (99000, 99001, C9150, J1170, J2001, J8520, J8521, J9258, 0078U, 0167U, 0396U) from billing system. Configure prior authorization requirements for codes marked with asterisk (L1006, J3393, J3394). Submit corrected claims for retroactive coverage codes (90634, 90743, J7354, G9886, G9887, G9888, J3393, J3394) back to their respective effective dates. For FQHCs providing vaccines under 340B program, ensure 340B acquisition price is reported on claims.

Affected Billing Codes

J0138
J1171
J2002
J2003
J2004
J2252
J2601
J9329
Q5135
L1006
L1653
L1821
J9325
S0013
J3393
J3394
90634
90743
J7354
G9886
G9887
G9888
G9037
G9038
99000
99001
G9873
G9874
G9875
G9876
G9877
G9878
G9879
G9891
G9882
G9883
G9884
G9885
C9150
J1170
J2001
J8520
J8521
J9258