Summary
Effective for dates of service on and after January 1, 2019, Michigan Medicaid adopted the annual HCPCS code updates for each listed provider type and activated existing codes for coverage for the provider types listed. Any new procedure code not listed will not be covered at this time, except for reporting codes, and the 2018 codes listed in the update were discontinued effective December 31, 2018. Some codes received retroactive coverage or modifier requirements for dates of service on and after January 1, 2018, and school based therapy services must be billed with modifiers GP, GO or GN to identify the therapy discipline.
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 · 6 steps
01Already effective January 1, 2019: Bill these codes only for the provider groups allowed to bill them, since any new procedure code not listed will not be covered at this time except for reporting codes.
02Obtain prior authorization before billing HCPCS codes marked with an asterisk, which the notice identifies as requiring PA.
03Bill school based therapy services with modifier GP, GO or GN for physical, occupational or speech-language therapy, and add modifier 96 when habilitative therapy is provided.
04Bill V5241 with modifier LT or RT for dates of service on and after January 1, 2018.
05Coverage of S4989 was discontinued effective December 31, 2018, and the 2018 codes listed in the update were discontinued effective December 31, 2018.
06Check current applicability before acting.
Codes mentioned
1000410005100061000710008100091001011102111031110411105111061110720932209332093427369332743327533285332863328933440338663657236573385314376243763504365043753854763917697876979769817698276983770467704777048770499227392274932649583695976959779598395984961129611396121961309613196132961339613696137961389613996146994519945299453994549945799491A9513A9589G2010G2012J0185J0517J0567J0584J0599J0841J1095J1301J1454J1628J1746J2062J2186J2787J2797J3245J3304J3316J3397J3398J3591J7170J7177J7203J7318J7329J9044J9057J9153J9173J9229J9311J9312L8608Q5107Q5109Q5111Q2042D1516D1517D9944D994681163811648116581166811678117181172811738117481177811788117981180811818118281183811848118581186811878118881189811908120481233812348123681237812398127181274812848128581286812898130581306813128132081329813338133681337813438134481345815188159683722A6460A6461B4105L86988763187651908679086890869994469944799448994499948999490G0460G0475Q4132Q4133Q0111Q0112Q0113Q0114Q01158116281260812918142281507815088150981510815118151283516J0604V5241D1354S4989100221110011101200052737031595332823328441500437604676250395613326148061610616126361564508645506622076001770587705978270782717827281211812138121492275959749597595978959799610196102961039611196118961199612099090C8904C8907C9014C9015C9016C9024C9028C9029C9030C9031C9032C9033C9275C9463C9464C9465C9466C9467C9468C9492C9493C9497C9741C9744C9748C9750D1515D1525D5281D9940G9534G9535G9536G9538G9686J0833J9310K0903Q2040Q4131Q4172Q9993Q9994Q9995V5170V5180V5210V5220
Original notice
MSA 19-01
michigan.gov · Always check the source before changing claims.
Related changes
See all Michigan Medicaid - MDHHS changes →Related policy hubs
Michigan Medicaid - MDHHS policiesMI policy changesGeneral PracticeDentistryPodiatryOral & Maxillofacial SurgeryOptometryPathologyPediatricsOB-GYNCode 10004Code 10005Code 10006Code 10007Code 10008Code 10009Code 10010Code 11102Code 11103Code 11104Code 11105Code 11106Code 11107Code 20932Code 20933Code 20934Code 27369Code 33274Code 33275Code 33285Code 33286Code 33289Code 33440Code 33866Code 36572Code 36573Code 38531Code 43762Code 43763Code 50436Code 50437Code 53854Code 76391Code 76978Code 76979Code 76981Code 76982Code 76983Code 77046Code 77047Code 77048Code 77049Code 92273Code 92274Code 93264Code 95836Code 95976Code 95977Code 95983Code 95984Code 96112Code 96113Code 96121Code 96130Code 96131Code 96132Code 96133Code 96136Code 96137Code 96138Code 96139Code 96146Code 99451Code 99452Code 99453Code 99454Code 99457Code 99491Code A9513Code A9589Code G2010Code G2012Code J0185Code J0517Code J0567Code J0584Code J0599Code J0841Code J1095Code J1301Code J1454Code J1628Code J1746Code J2062Code J2186Code J2787Code J2797Code J3245Code J3304Code J3316Code J3397Code J3398Code J3591Code J7170Code J7177Code J7203Code J7318Code J7329Code J9044Code J9057Code J9153Code J9173Code J9229Code J9311Code J9312Code L8608Code Q5107Code Q5109Code Q5111Code Q2042Code D1516Code D1517Code D9944Code D9946Code 81163Code 81164Code 81165Code 81166Code 81167Code 81171Code 81172Code 81173Code 81174Code 81177Code 81178Code 81179Code 81180Code 81181Code 81182Code 81183Code 81184Code 81185Code 81186Code 81187Code 81188Code 81189Code 81190Code 81204Code 81233Code 81234Code 81236Code 81237Code 81239Code 81271Code 81274Code 81284Code 81285Code 81286Code 81289Code 81305Code 81306Code 81312Code 81320Code 81329Code 81333Code 81336Code 81337Code 81343Code 81344Code 81345Code 81518Code 81596Code 83722Code A6460Code A6461Code B4105Code L8698Code 87631Code 87651Code 90867Code 90868Code 90869Code 99446Code 99447Code 99448Code 99449Code 99489Code 99490Code G0460Code G0475Code Q4132Code Q4133Code Q0111Code Q0112Code Q0113Code Q0114Code Q0115Code 81162Code 81260Code 81291Code 81422Code 81507Code 81508Code 81509Code 81510Code 81511Code 81512Code 83516Code J0604Code V5241Code D1354Code S4989Code 10022Code 11100Code 11101Code 20005Code 27370Code 31595Code 33282Code 33284Code 41500Code 43760Code 46762Code 50395Code 61332Code 61480Code 61610Code 61612Code 63615Code 64508Code 64550Code 66220Code 76001Code 77058Code 77059Code 78270Code 78271Code 78272Code 81211Code 81213Code 81214Code 92275Code 95974Code 95975Code 95978Code 95979Code 96101Code 96102Code 96103Code 96111Code 96118Code 96119Code 96120Code 99090Code C8904Code C8907Code C9014Code C9015Code C9016Code C9024Code C9028Code C9029Code C9030Code C9031Code C9032Code C9033Code C9275Code C9463Code C9464Code C9465Code C9466Code C9467Code C9468Code C9492Code C9493Code C9497Code C9741Code C9744Code C9748Code C9750Code D1515Code D1525Code D5281Code D9940Code G9534Code G9535Code G9536Code G9538Code G9686Code J0833Code J9310Code K0903Code Q2040Code Q4131Code Q4172Code Q9993Code Q9994Code Q9995Code V5170Code V5180Code V5210Code V5220