Summary
The April 2018 update to the Michigan Medicaid Provider Manual and a streamlined format for the MDHHS OPPS Wrap Around Code List took effect April 1, 2018. ACT psychiatric telepractice must be reported with modifier 95 and ACT encounter code H0039, and ACT pre-admission screens must be reported with modifier TG and H0039. Providers must complete the Children's Oral Health training and certification before billing Medicaid for oral health screenings and fluoride varnish applications.
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What to do
Action · 5 steps
01Already effective April 1, 2018 ; check current applicability before billing): For ACT psychiatric services provided by telepractice, use the telepractice modifier 95 with ACT encounter code H0039, and provide these services only through real-time interaction between the ACT consumer and the physician or nurse practitioner.
02For ACT pre-admission screens, report modifier TG with ACT encounter code H0039.
03Providers who perform oral health screenings or apply fluoride varnish must complete the online Children's Oral Health training modules and obtain certification before billing Medicaid, and must submit certification of completion of Module 6 (Fluoride Varnish) to the MDHHS Oral Health Program before billing.
04Routine eye examinations by an optometrist or ophthalmologist once every two years are a Medicaid benefit and do not require prior authorization.
05The maternal depression screening is billed under the infant's Medicaid ID number using the appropriate CPT code.
Codes mentioned
H0039
Original notice
MSA 18-06
michigan.gov · Always check the source before changing claims.
Related changes
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