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Michigan Medicaid - MDHHSMedicaid · Billing Codes · Provider Bulletin · MI · General Practice, EndocrinologyMedium impact

MMP 23-33: Michigan Diabetes Prevention Program (MiDPP)

Effective date
Jul 1, 2023
Identified
Jun 20, 2026

Summary

Effective for dates of service on or after July 1, 2023, Michigan Medicaid may reimburse the CDC-recognized Diabetes Prevention Program, called MiDPP, when it is provided to eligible Medicaid beneficiaries 18 years and older by enrolled Medicaid MiDPP providers. MiDPP is a preventive service with no beneficiary cost-sharing, and implementation is contingent on CMS approval of a State Plan Amendment. Beneficiaries must be overweight or obese by BMI and have elevated blood glucose, a history of gestational diabetes, or a high-risk score on the CDC prediabetes risk test, and those with previously diagnosed type 1 or type 2 diabetes or who are currently pregnant cannot enroll.

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What to do

Action · 7 steps
01Already effective July 1, 2023: Check current applicability of MiDPP billing before using these codes.
02Billing team: submit MiDPP claims on a professional claim format, with an approved MiDPP HCPCS code and the diagnosis code Z71.89.
03Core sessions in months 1 to 6 use G9873, G9874 or G9875, and core maintenance sessions in months 7 to 12 use G9876, G9877, G9878 or G9879, with G9891 included on the session dates when a payable attendance milestone is achieved.
04Weight loss that meets a coding requirement must be documented in the beneficiary's program record.
05For beneficiaries enrolled in a Medicaid Health Plan or ICO, check with the beneficiary's health plan for prior authorization or referral requirements.
06Audio-only telemedicine claims must include modifier 93 and audio-visual telemedicine claims must include modifier 95, each with the place of service code.
07Asynchronous session claims must include the procedure code and the remark 'Service provided via an asynchronous telemedicine platform'.

Codes mentioned

G9873G9874G9875G9876G9877G9878G9879G9880G9881G9890G9891Z71.89

Original notice

MMP 23-33: Michigan Diabetes Prevention Program (MiDPP)
michigan.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Michigan Medicaid - MDHHS changes →
MMP 24-25: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2024 · Claims & BillingMMP 24-50: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Oct 1, 2024 · Claims & BillingMMP 25-06: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jan 1, 2025 · Claims & BillingBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesGeneral PracticeEndocrinologyCode G9873Code G9874Code G9875Code G9876Code G9877Code G9878Code G9879Code G9880Code G9881Code G9890Code G9891Code Z71.89

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