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MedicaidReimbursementMedium impact

MMP 24-52: Implementation of the Legislatively Mandated Methadone Services Reimbursement Rate Increase

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

Summary

Michigan Medicaid has increased the minimum reimbursement rate for methadone administration services (HCPCS code H0020) to $19.00 per unit, effective October 1, 2024. This legislatively mandated rate increase applies to Medicaid and Healthy Michigan Plan beneficiaries served through Prepaid Inpatient Health Plans.

Action Required

Action needed
Immediately: Billing team should verify that claims for methadone administration services using HCPCS code H0020 are being reimbursed at the new minimum rate of $19.00 per unit for Michigan Medicaid and Healthy Michigan Plan patients. Contact PIHPs if reimbursement rates are below this threshold. Update fee schedules and contracts as needed to reflect the new minimum rate.

Affected Billing Codes

H0020