MedicaidCoverageMedium impact
MSA 18-52
Michigan Medicaid - MDHHS·MI · Pediatrics, Family Medicine·Provider Bulletin
Effective date
Feb 1, 2019
We identified it
Jun 20, 2026
Summary
Michigan Medicaid clarifies that providers can use clinical judgment for blood lead testing follow-up actions even when levels are below the 5 μg/dL reference value. This guidance allows billing for additional testing, evaluations, and case management services for children with lower lead levels if clinically indicated.
Action Required
By February 1, 2019: Providers should review clinical protocols for blood lead testing follow-up. Update documentation practices to support medical necessity when ordering repeat testing, follow-up evaluations, or case management services for children with blood lead levels below 5 μg/dL. Ensure billing staff understand that additional services may be covered when clinically justified even with lower lead levels.