MedicaidCoverageMedium impact
HASA 22-06
Michigan Medicaid - MDHHS·MI · Genetics·Provider Bulletin
Effective date
Apr 1, 2022
We identified it
Jun 20, 2026
Summary
Michigan Medicaid will now enroll genetic counselors as providers and reimburse for genetic counseling services starting April 1, 2022. Genetic counselors can bill directly using CPT code 96040 for medically necessary counseling services when referred by enrolled physicians, PAs, or APRNs.
Action Required
Effective April 1, 2022: Billing teams in Michigan should update systems to recognize genetic counselors as eligible Medicaid providers. Add CPT code 96040 for genetic counseling services (30-minute face-to-face sessions). Ensure claims include genetic counselor NPI in rendering provider field and referring physician NPI in ordering provider field. Genetic counselors must enroll in CHAMPS system with Individual Type 1 NPI to be eligible for direct reimbursement.