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Michigan Medicaid - MDHHSMedicaid · Administrative · Provider Bulletin · MIMedium impact

MSA 20-43

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

Summary

This historical 2020 Michigan Medicaid update includes dated billing changes. Prior authorization applied to HCPCS A7000 for dates of service on and after March 1, 2020 (temporarily lifted under MSA 20-14 during the COVID-19 emergency), and to HCPCS 97763 for nursing facilities on and after May 1, 2020. New coverage was added for U0001 and U0002 (effective February 4, 2020), 86328 and 86769 (effective April 10, 2020), and U0003 and U0004 (effective April 14, 2020). The update also clarified that only interfacility hospital transfers and transports after hospital discharge may be made without an attending physician written order, and all other non-emergency ambulance transports still require that order.

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What to do

Action · 9 steps
01Already effective February 4, 2020, April 10, 2020, and April 14, 2020: Billing team: bill U0001 and U0002 for dates of service from February 4, 2020, 86328 and 86769 from April 10, 2020, and U0003 and U0004 from April 14, 2020, for the practitioner and clinic types listed in the source.
02Already effective March 1, 2020: Billing team: obtain prior authorization for A7000 for dates of service on and after that date.
03Already effective March 31, 2020: MDHHS discontinued the prior authorization requirement for K0195-RR effective that date.
04Already effective May 1, 2020: Nursing facilities need prior authorization for HCPCS 97763.
05Already effective April 1, 2020: Billing team: OPPS wrap-around codes with the UC modifier change to the SL modifier, and the source states this does not affect the rate or status indicator.
06Billing team: for interfacility hospital transfers and transports after hospital discharge made without an attending physician written order, include the attending physician NPI on the claim.
07All other non-emergency ambulance transports still require an attending physician written order.
08Billing team: for telepractice individual or family therapy using approved children's evidence-based practices, report the GT modifier.
09Federally Qualified Health Centers and Rural Health Clinics: disclose ownership information to MDHHS within 35 days of a change of ownership.
If missed: Failure to notify MDHHS of a change in identification information may result in loss of Medicaid enrollment, lapse of provider eligibility, or nonpayment of services.

Codes mentioned

U0001U00028632886769U0003U0004A700097763K0195H0039

Original notice

MSA 20-43
michigan.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Michigan Medicaid - MDHHS changes →
MSA 20-52MediumEffective May 26, 2020 · Provider BulletinMSA 20-17HighEffective Apr 1, 2020 · Provider BulletinMMP 23-24: COVID-19 Response: Continuation of COVID-19 Laboratory PoliciesMediumEffective May 12, 2023 · Provider BulletinMMP 23-25: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Apr 1, 2023 · Claims & BillingBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesCode U0001Code U0002Code 86328Code 86769Code U0003Code U0004Code A7000Code 97763Code K0195Code H0039

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