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Michigan Medicaid - MDHHSMedicaid · Billing Codes · Claims & Billing · MIMedium impact

MMP 23-63: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Act
immediately
Effective date
Oct 1, 2023
Identified
Jun 20, 2026

Summary

Michigan Medicaid has updated CPT and HCPCS code coverage effective October 1, 2023, adding new covered codes for various provider types and discontinuing others. The changes include new drug codes, vaccine codes, and diagnostic codes, with some requiring prior authorization.

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What to do

immediately · 4 steps
01Billing team must update Michigan Medicaid billing system to include newly covered codes effective October 1, 2023.
02Add prior authorization requirements for codes marked with asterisk (Q2041, Q2042, Q2053, Q0478, Q0479, L5848).
03Stop billing discontinued codes C9151, J0800, 0066U, 0357U, 0386U, 0397U as of September 30, 2023.
04Verify provider type eligibility for each new code in CHAMPS system before billing.

Codes mentioned

J0349J0801J0802J0874J2359J2781J7214J7519J9345905819058490738J7330Q2041Q2042Q2053903809038190678906799638096381Q0478Q04798254283520904809131891319913209132191322M020191304L5848913129131391314913159131691317C9151J0800

Original notice

MMP 23-63: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
michigan.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Michigan Medicaid - MDHHS changes →
MMP 22-37MediumEffective Oct 1, 2022 · Provider BulletinMSA 19-07MediumEffective Jan 1, 2019 · Provider BulletinMMP 23-08: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesMediumEffective Jan 1, 2023 · Claims & BillingMMP 24-39: Medicaid Program Rate Updates Fiscal Year (FY) 2025; Federally Qualified Health Center (FQHC) Reimbursement UpdateHighEffective Oct 1, 2024 · Claims & BillingBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesCode J0349Code J0801Code J0802Code J0874Code J2359Code J2781Code J7214Code J7519Code J9345Code 90581Code 90584Code 90738Code J7330Code Q2041Code Q2042Code Q2053Code 90380Code 90381Code 90678Code 90679Code 96380Code 96381Code Q0478Code Q0479Code 82542Code 83520Code 90480Code 91318Code 91319Code 91320Code 91321Code 91322Code M0201Code 91304Code L5848Code 91312Code 91313Code 91314Code 91315Code 91316Code 91317Code C9151Code J0800

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