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MedicaidReimbursementHigh impact

MSA 20-07

Michigan Medicaid - MDHHS·MI · Critical Care, Pediatrics·Provider Bulletin
Effective date
Feb 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid is increasing reimbursement rates for neonatal and pediatric critical care services to 95% of Medicare rates, effective February 1, 2020. This affects 10 specific CPT codes for critical care and intensive care services for newborns and children.

Action Required

Action needed
Immediately: Billing team must verify that Michigan Medicaid claims for CPT codes 99468-99480 are being reimbursed at the new 95% of Medicare rate. Update fee schedules and verify contracted rates with Medicaid health plans. Monitor reimbursement to ensure correct payment levels are received.

Affected Billing Codes

99468
99469
99471
99472
99475
99476
99477
99478
99479
99480