MedicaidReimbursementHigh impact
MSA 20-20
Michigan Medicaid - MDHHS·MI · Family Medicine, General Practice, OB-GYN·Provider Bulletin
Effective date
Jun 1, 2020
We identified it
Jun 20, 2026
Summary
Michigan Rural Health Clinics can now choose between two reimbursement methodologies for Medicaid programs: the traditional Prospective Payment System (PPS) or a new Alternative Payment Methodology (APM) requiring a signed Memorandum of Understanding. Selected procedures like endometrial ablation and hysteroscopy receive individual practitioner rates under APM.
Action Required
By June 1, 2020: Rural Health Clinics must decide between PPS or APM reimbursement methodology. If choosing APM, sign and return the Memorandum of Understanding distributed by MDHHS to the address provided. Update billing procedures for selected procedures (endometrial ablation, hysteroscopy, colposcopy, post-partum care, drug delivery implant insertion/removal) which will be reimbursed at individual practitioner rates under APM. For inpatient hospital services, bill under individual practitioner's Medicaid provider number, not RHC Billing NPI. Claims without proper methodology selection will default to PPS base rate.