MedicaidCoverageMedium impact
MSA 19-25
Michigan Medicaid - MDHHS·MI · Orthopedics, PM&R (Physical Medicine & Rehab), Podiatry·Provider Bulletin
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has revised coverage standards for lower extremity orthotics, expanding coverage to include devices for healing/alignment after injuries or surgeries, supporting muscle weakness, and correcting biomechanical issues regardless of diagnosis. The policy affects Medicaid Fee-for-Service, Health Plans, and ICOs.
Action Required
By October 1, 2019: Billing team must review current lower extremity orthotic claims processes for Michigan Medicaid patients. Update billing procedures to reflect expanded coverage criteria including post-injury healing, muscle weakness support, and biomechanical corrections. Verify prior authorization requirements with individual Medicaid Health Plans and ICOs as they may have additional requirements beyond Fee-for-Service rules.