MedicaidCoverageMedium impact
MSA 18-03
Michigan Medicaid - MDHHS·MI · Orthopedics, PM&R (Physical Medicine & Rehab), Physical Therapy +1 more·Provider Bulletin
Effective date
Jan 30, 2018
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has reorganized its age limitation policies for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), moving age restrictions from separate sections into Medical Necessity and Age Factors sections. Coverage determinations now emphasize evidence-based guidelines and allow prior authorization requests when age limitations exist.
Action Required
Immediately: Billing team should review Michigan Medicaid Provider Manual for updated DMEPOS age limitation requirements in the Medical Necessity and Age Factors sections. For DMEPOS claims exceeding age limits, prepare to submit prior authorization requests with comprehensive medical documentation demonstrating medical necessity. Reference CHAMPS Medicaid Code Rate and Reference tool for specific HCPCS codes and age limits.