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MedicaidBilling CodesMedium impact

MSA 18-32

Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Oct 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid updated the Provider Manual with clarifications to customary charge definitions for billing free/reduced services, added new HCPCS codes requiring coverage or prior authorization, and discontinued several codes. The policy also expands psychiatric services to include physician assistants under supervision.

Action Required

Action needed
By October 1, 2018: Billing team must obtain prior authorization for Q9994 code for medical suppliers. Stop billing discontinued codes C9469 (as of June 30, 2018) and 0008M, 83992 (as of December 31, 2017). Add coverage for new Q codes (Q5105, Q5106, Q9993, Q9995) effective July 1, 2018. Review customary charge billing practices to ensure compliance with revised definition that excludes negotiated rates but allows billing Medicaid at customary charge for services offered free/reduced to general public.

Affected Billing Codes

Q5105
Q5106
Q9993
Q9995
Q9994
A9274
H0010
H0012
H0014
H0019
H0020
H0022
H0023
H0025
H0032
H0033
H0038
H0043
H0045
H0046
H0050
H2010
H2014
H2016
H2019
H2023
H2035
T1007
T1012
T1016
T1027
T2015
T2037
C9469
83992