MedicaidCoverageMedium impact
HASA 22-11
Michigan Medicaid - MDHHS·MI · Pediatrics, Family Medicine, General Practice·Provider Bulletin
Effective date
May 1, 2022
We identified it
Jun 20, 2026
Summary
Michigan updated the blood lead reference value (BLRV) from 5 μg/dL to 3.5 μg/dL and revised medical management recommendations for childhood lead exposure. Case management services for children with BLRV ≥3.5 μg/dL are covered under Children's Special Health Care Services with a maximum of six billing units per year.
Action Required
By May 1, 2022: Billing team must update procedures to recognize the new blood lead reference value of 3.5 μg/dL (down from 5 μg/dL) for case management billing eligibility. Ensure staff understand that children with blood lead levels ≥3.5 μg/dL are eligible for up to 6 CSHCS case management billing units per year without requiring CSHCS enrollment. Update clinical protocols and billing guidelines to reflect new AAP management recommendations for different blood lead level ranges.