Who is affected by this change?

This affects Michigan Medicaid - MDHHS in MI on Medicaid plans.

When does this change take effect?

This change is effective Jul 1, 2023.

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

MMP 23-51: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Q: What do I need to do?

Immediately: Billing team must update billing software to include new J-codes, therapy codes (98975-98981), and oncology codes effective July 1, 2023. Remove all discontinued codes from system including COVID vaccine codes discontinued April 17, 2023, and various other codes discontinued on different dates. Verify provider type eligibility for each new code before billing. Check CHAMPS system for prior authorization requirements marked with asterisk (*) including J0174 and Q5131.

Q: Which billing codes are affected?

The following codes are affected: J0137, J0174, J0206, J0216, J0457, J0665, J0736, J0737, J1440, J1576, J1805, J1806, J1811, J1812, J1813, J1814, J1836, J1920, J1921, J1941, J1961, J2249, J2305, J2329, J2371, J2372, J2427, J2561, J2598, J2599, J2806, J7213, J9029, J9056, J9058, J9059, J9063, J9259, J9322, J9323, J9347, J9350, J9380, J9381, Q5131, 98975, 98976, 98977, 98980, 98981, 91303, L1685, L1686, L3763, L3915, L3916, L3923, L3924, L5856, L5857, L5858, L5859, L5985, L5987, 46900, 91300, 91301, 91305, 91306, 91307, 91308, 91309, 91311, M0220, M0221, Q0220, Q0221, M0222, M0223, Q0222, M0247, M0248, Q0247, M0240, M0241, M0243, M0244, M0245, M0246, Q0240, Q0243, Q0244, Q0245, C9146, C9147, C9148, C9149, J2370, S0020, S0030, S0073, S0077.

Act

immediately

Effective date

Jul 1, 2023

Identified

Jun 20, 2026

Summary

Michigan Medicaid updated CPT and HCPCS codes effective July 1, 2023, adding 43 new codes for various provider types and discontinuing multiple codes on different dates. The changes affect billing for drugs, injections, and certain procedures across multiple specialties.

Get alerts when payers change rules like this one

We check Michigan Medicaid - MDHHS and other payers every day and email you when a change matches your specialty and state.

Get Michigan Medicaid - MDHHS alertsPolicy Monitoring is free. No card required.

What to do

immediately · 4 steps

01Billing team must update billing software to include new J-codes, therapy codes (98975-98981), and oncology codes effective July 1, 2023.

02Remove all discontinued codes from system including COVID vaccine codes discontinued April 17, 2023, and various other codes discontinued on different dates.

03Verify provider type eligibility for each new code before billing.

04Check CHAMPS system for prior authorization requirements marked with asterisk (*) including J0174 and Q5131.

Codes mentioned

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

Original notice

MMP 23-51: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

michigan.gov · Always check the source before changing claims.

View original ↗

MMP 25-14: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Apr 1, 2025 · Claims & Billing HASA 22-03MediumEffective Jan 1, 2022 · Provider Bulletin MSA 21-35MediumNo effective date · Provider Bulletin HASA 22-18MediumEffective Apr 1, 2022 · Provider Bulletin Browse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policies MI policy changes Code J0137 Code J0174 Code J0206 Code J0216 Code J0457 Code J0665 Code J0736 Code J0737 Code J1440 Code J1576 Code J1805 Code J1806 Code J1811 Code J1812 Code J1813 Code J1814 Code J1836 Code J1920 Code J1921 Code J1941 Code J1961 Code J2249 Code J2305 Code J2329 Code J2371 Code J2372 Code J2427 Code J2561 Code J2598 Code J2599 Code J2806 Code J7213 Code J9029 Code J9056 Code J9058 Code J9059 Code J9063 Code J9259 Code J9322 Code J9323 Code J9347 Code J9350 Code J9380 Code J9381 Code Q5131 Code 98975 Code 98976 Code 98977 Code 98980 Code 98981 Code 91303 Code L1685 Code L1686 Code L3763 Code L3915 Code L3916 Code L3923 Code L3924 Code L5856 Code L5857 Code L5858 Code L5859 Code L5985 Code L5987 Code 46900 Code 91300 Code 91301 Code 91305 Code 91306 Code 91307 Code 91308 Code 91309 Code 91311 Code M0220 Code M0221 Code Q0220 Code Q0221 Code M0222 Code M0223 Code Q0222 Code M0247 Code M0248 Code Q0247 Code M0240 Code M0241 Code M0243 Code M0244 Code M0245 Code M0246 Code Q0240 Code Q0243 Code Q0244 Code Q0245 Code C9146 Code C9147 Code C9148 Code C9149 Code J2370 Code S0020 Code S0030 Code S0073 Code S0077

MMP 23-51: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Summary

Get alerts when payers change rules like this one

What to do

Codes mentioned

Original notice

Related changes

Related policy hubs

One workspace for payer rules, prior auth, coding and compliance