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Michigan Medicaid - MDHHSMedicaid · Billing Codes · Provider Bulletin · MI · Physical Therapy, Occupational Therapy, Speech Therapy +1 moreMedium impact

MSA 18-29

Effective date
Oct 1, 2018
Identified
Jun 20, 2026

Summary

Michigan Medicaid enrolls private practice occupational therapists, physical therapists, speech-language pathologists and audiologists for direct reimbursement, effective for dates of service on and after January 1, 2018. Effective October 1, 2018, MDHHS discontinues procedure code 97760 for serial casting, which is reported with CPT 97140 and appropriate therapy modifiers instead, and all therapy services must be billed with a modifier that identifies the discipline. The bulletin also introduces a new Therapy Services chapter of the Medicaid Provider Manual, a revised MSA-115 prior authorization form and changes outpatient therapy treatment periods from 12 consecutive months to a calendar year.

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What to do

Action · 9 steps
01Already effective October 1, 2018: Therapy providers must bill therapy services with a modifier that identifies the discipline: GP for physical therapy, GO for occupational therapy, or GN for speech-language therapy.
02Use modifier 96 to identify habilitative therapy and modifier 97 to identify rehabilitative therapy, and bill maintenance therapy with the TS modifier.
03Therapy services submitted without these modifiers may be denied.
04Report serial casting with CPT 97140 and the appropriate therapy modifiers, because MDHHS discontinued procedure code 97760 for dates of service on or after October 1, 2018.
05Use the revised MSA-115 form for therapy prior authorization requests for services provided on or after October 1, 2018.
06The MSA-115 must be typewritten, and the form and all attachments must include the beneficiary name, mihealth card number, provider name and address, and provider NPI.
07Submit it to the MDHHS Program Review Division by mail or fax, electronically, or through FFS Direct Data Entry in CHAMPS.
08For beneficiaries enrolled in a Medicaid Health Plan, contact the health plan for enrollment, coverage and reimbursement information.
09Check current applicability of these 2018 requirements before acting on them.

Codes mentioned

9776097140

Original notice

MSA 18-29
michigan.gov · Always check the source before changing claims.
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Related changes

See all Michigan Medicaid - MDHHS changes →
MSA 20-22HighEffective Mar 1, 2020 · Provider BulletinMMP 23-67: Skilled Maintenance TherapyHighEffective Jan 1, 2024 · Provider BulletinMMP 23-38: Updates to the MDHHS Medicaid Provider ManualMediumEffective Jul 1, 2023 · Medical PolicyBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesPhysical TherapyOccupational TherapySpeech TherapyAudiologyCode 97760Code 97140

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