MedicaidReimbursementHigh impact
MMP 24-39: Medicaid Program Rate Updates Fiscal Year (FY) 2025; Federally Qualified Health Center (FQHC) Reimbursement Update
Michigan Medicaid - MDHHS·MI · Allergy & Immunology, Family Medicine, General Practice +6 more·Claims & Billing
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
Michigan Medicaid is implementing several reimbursement rate increases effective October 1, 2024, including vaccine administration rates increasing to $23.03 for patients under 19, behavioral health services reimbursed at 90% of practitioner rates, and 23% increases for speech therapy services. FQHCs will now be reimbursed separately for vaccines outside their usual payment system.
Action Required
By October 1, 2024: Billing team must update fee schedules in billing system to reflect new rates - $23.03 for vaccine administration codes (90460, 90471-90474, 96380-96381, G0008-G0010) for patients under 19 years old, 23% increase for speech therapy codes (31579, 92507-92633, 92700, 94010, 97129-97130, 97533, 97799, G2250-G2251, S9152), and 25% increase for private duty nursing. Update billing software to calculate behavioral health services at 90% of Medicaid practitioner rates and orthotic/prosthetic devices at 74% of Medicare rates. FQHCs must update systems to bill vaccines separately from PPS rates for patients 19+ years old.