Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Michigan Medicaid - MDHHSMedicaid · Billing Codes · Provider Bulletin · MI · Dentistry, Pharmacy, Audiology +7 moreMedium impact

MSA 21-35

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

MDHHS updated the Michigan Medicaid Provider Manual in October 2021 with code changes for dates of service on and after July 1, 2021, including new HCPCS codes J0224, J1951, J7168, J9348, J9353 and Q5123 and new coverage of existing codes 99174, 99177 and Q4163. Retroactive coverage was added for codes M0244, M0246, M0247, M0248, Q0247, Q0244 and M0201, with start dates from May 6, 2021 to June 8, 2021. Codes C9074 and C9132 were discontinued effective June 30, 2021, and dental billing instructions for eligibility changes, incomplete procedures and orthodontic treatment were moved into the Billing & Reimbursement for Dental Providers chapter.

Get alerts when payers change rules like this one

We check Michigan Medicaid - MDHHS and other payers every day and email you when a change matches your specialty and state.

Get Michigan Medicaid - MDHHS alertsPolicy Monitoring is free. No card required.

What to do

Action · 7 steps
01Already effective July 1, 2021: Billing team should bill the newly adopted codes only for the provider groups the source lists for each code, for example J1951 for Federally Qualified Health Centers, Rural Health Clinics and Tribal Health Centers.
02Codes marked with an asterisk require prior authorization (PA).
03For codes covered differently than Medicare, check the OPPS and ASC Wrap-Around Code List on the MDHHS website.
04Codes C9074 and C9132 were discontinued effective June 30, 2021, so stop billing them.
05For dental claims, use the date of the initial impression as the date of service for complete or partial dentures and laboratory processed crowns and enter the completion date in the Remarks section; bill D2999 with the date of the impression for an incomplete crown, D3999 with the date of the first treatment appointment for an incomplete root canal, and D5899 with the date of the initial impression for an incomplete denture; include the PA number on each of these claims.
06For interceptive orthodontic treatment, submit a single claim for the entire treatment phase with the banding/start date as the date of service, include the PA number, and note that reimbursement is considered payment in full.
07For beneficiaries enrolled in a Medicaid Health Plan, the provider must contact the health plan for claim completion instructions, which may vary from the FFS Medicaid program.

Codes mentioned

J0224J1951J7168J9348J9353Q51239917499177Q4163M0244M0246M0247M0248Q0247Q0244M0201C9074C9132D2999D3999D5899

Original notice

MSA 21-35
michigan.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Michigan Medicaid - MDHHS changes →
MMP 23-51: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2023 · Claims & BillingHASA 22-03MediumEffective Jan 1, 2022 · Provider BulletinMMP 25-14: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Apr 1, 2025 · Claims & BillingMSA 21-02MediumEffective May 1, 2021 · Provider BulletinBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesDentistryPharmacyAudiologyOptometryCardiologyPediatricsPsychiatryOB-GYNPodiatryGeneral PracticeCode J0224Code J1951Code J7168Code J9348Code J9353Code Q5123Code 99174Code 99177Code Q4163Code M0244Code M0246Code M0247Code M0248Code Q0247Code Q0244Code M0201Code C9074Code C9132Code D2999Code D3999Code D5899

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account