MedicaidBilling CodesMedium impact
MMP 24-47: Pharmacy Secondary Payer Coverage of Select Continuous Glucose Monitoring Systems (CGMS), Disposable Insulin Pumps, and Related Supplies
Michigan Medicaid - MDHHS·MI · Endocrinology, Family Medicine, Internal Medicine +2 more·Pharmacy
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
Starting October 1, 2024, Michigan Medicaid will allow select continuous glucose monitoring systems and disposable insulin pumps to be billed through pharmacy claims when Medicaid is the secondary payer. These items can only be billed as coordination of benefits claims using specific NCPDP codes, otherwise they will be rejected.
Action Required
By October 1, 2024: Pharmacy staff must update billing procedures for Dexcom, Freestyle Libre, and Omnipod products when billing Michigan Medicaid as secondary payer. Use NCPDP Other Coverage codes 2 (coinsurance) or 4 (deductible) in field 308-C8. Claims without these codes will be rejected. Update billing system to prevent primary billing to Medicaid for these products - they will be denied if not billed as coordination of benefits.