Summary
Michigan Medicaid has increased reimbursement rates for primary care services effective October 1, 2022. This applies to specific E/M codes including office visits, nursing facility services, home visits, preventive care, and telehealth services for Medicaid, Healthy Michigan Plan, and MI Child programs.
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What to do
immediately · 2 steps
01Billing team must verify that the enhanced primary care reimbursement rates are being applied to the specified CPT codes for Michigan Medicaid claims dated October 1, 2022 and after.
02Check the updated fee schedule on the MDHHS website at www.michigan.gov/medicaidproviders under Billing & Reimbursement >> Provider Specific Information >> Physicians/Practitioners/Medical Clinics to ensure correct payment amounts are being received.
Codes mentioned
992029920399204992059921199212992139921499215993049930599306993079930899309993109931599316993189932499325993269932799328993349933599336993379934199342993439934499345993479934899349993509938199382993839938499385993869938799391993929939399394993959939699397994219942299423994419944299443
Original notice
MMP 22-33
michigan.gov · Always check the source before changing claims.
Related changes
See all Michigan Medicaid - MDHHS changes →MSA 16-46MediumEffective Feb 1, 2017 · Provider BulletinMSA 17-13MediumEffective Jul 1, 2017 · Provider BulletinMMP 23-08: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesMediumEffective Jan 1, 2023 · Claims & BillingMSA 21-19MediumEffective Aug 1, 2021 · Provider BulletinBrowse every Michigan Medicaid - MDHHS change in the policy list
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