MedicaidBilling CodesHigh impact
MMP 23-50: Updates and Clarification to Coverage and Reimbursement of Anesthesia Services
Michigan Medicaid - MDHHS·MI · Anesthesiology, General Surgery, Dentistry +2 more·Claims & Billing
Effective date
Sep 1, 2023
We identified it
Jun 20, 2026
Summary
Michigan Medicaid updated anesthesia coverage and reimbursement policies, clarifying qualified providers (including CRNAs and anesthesiologist assistants), defining sedation levels, and establishing specific billing modifier requirements with different reimbursement percentages. The policy establishes that anesthesia services by surgeons are bundled into surgical procedure payments.
Action Required
By September 1, 2023: Billing team must update Michigan Medicaid anesthesia claims to include required modifiers (AA, AD, QK, QS, QX, QY, QZ) on all CPT codes 00100-01999. Update billing software to calculate reimbursement at 100% for AA and QZ modifiers, 50% for QK, QX, and QY modifiers, and flat rate for AD modifier. Train staff that surgeon-provided anesthesia cannot be billed separately. Claims without proper modifiers will be rejected.