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MMP 24-25: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
Act
immediately
Effective date
Jul 1, 2024
Identified
Jun 20, 2026
Summary
Michigan Medicaid has updated CPT and HCPCS code coverage effective July 1, 2024, adding new billable codes for various provider types and discontinuing coverage for others. The policy also clarifies billing procedures for gender-specific services and removes prior authorization requirements for certain codes.
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What to do
immediately · 5 steps
01Update billing system to include new covered HCPCS codes effective July 1, 2024 based on provider type (see policy sections A and B).
02Stop billing discontinued codes C9113, C9166, C9167, C9168, C9787, C9790, J2780, J9371, Q4210, Q4277, S0164, 0204U, 0353U as of June 30, 2024.
03Remove prior authorization requirement for code J0517 effective May 8, 2024.
04For gender-specific procedures that may conflict, append modifier KX to professional claims or use condition code 45 for institutional claims.
05Verify provider type eligibility for each new code before billing.
Codes mentioned
G9037G9038J0175J0211J0687J0872J0911J1597J1598J2183J2246J2267J2373J2468J2470J2471J3247J3263J7171J7355J9361Q4332Q5137Q5138Q4148Q4155Q4156Q4256Q4257Q4265Q4266Q4268Q4276Q4280Q4294Q4295Q4298Q4299Q430481551G9886G9887G9888J0517G9873G9874G9875G9876G9877G9878G9879G9891C9113C9166C9167C9168C9787C9790J2780J9371Q4210Q4277S0164
Original notice
MMP 24-25: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
michigan.gov · Always check the source before changing claims.
Related changes
See all Michigan Medicaid - MDHHS changes →MMP 24-50: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Oct 1, 2024 · Claims & BillingMMP 23-33: Michigan Diabetes Prevention Program (MiDPP)MediumEffective Jul 1, 2023 · Provider BulletinMMP 25-26: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2025 · Claims & BillingMMP 26-31: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2026 · Claims & BillingBrowse every Michigan Medicaid - MDHHS change in the policy list
Related policy hubs
Michigan Medicaid - MDHHS policiesMI policy changesCode G9037Code G9038Code J0175Code J0211Code J0687Code J0872Code J0911Code J1597Code J1598Code J2183Code J2246Code J2267Code J2373Code J2468Code J2470Code J2471Code J3247Code J3263Code J7171Code J7355Code J9361Code Q4332Code Q5137Code Q5138Code Q4148Code Q4155Code Q4156Code Q4256Code Q4257Code Q4265Code Q4266Code Q4268Code Q4276Code Q4280Code Q4294Code Q4295Code Q4298Code Q4299Code Q4304Code 81551Code G9886Code G9887Code G9888Code J0517Code G9873Code G9874Code G9875Code G9876Code G9877Code G9878Code G9879Code G9891Code C9113Code C9166Code C9167Code C9168Code C9787Code C9790Code J2780Code J9371Code Q4210Code Q4277Code S0164