MedicaidBilling CodesHigh impact
MMP 24-25: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
Michigan Medicaid - MDHHS·MI·Claims & Billing
Effective date
Jul 1, 2024
We identified it
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.
Action Required
Immediately: Update billing system to include new covered HCPCS codes effective July 1, 2024 based on provider type (see policy sections A and B). Stop billing discontinued codes C9113, C9166, C9167, C9168, C9787, C9790, J2780, J9371, Q4210, Q4277, S0164, 0204U, 0353U as of June 30, 2024. Remove prior authorization requirement for code J0517 effective May 8, 2024. For gender-specific procedures that may conflict, append modifier KX to professional claims or use condition code 45 for institutional claims. Verify provider type eligibility for each new code before billing.