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MedicaidAdministrativeMedium impact

MSA 17-44

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

Summary

Michigan Medicaid updated their provider manual with clarifications to timely filing rules for retroactive eligibility and allowed FQHCs, RHCs, and THCs to use modifier 25 in addition to modifier 59 for same-day services. The manual also added a new Freedom to Work benefit plan for disabled workers.

Action Required

Action needed
By January 1, 2018: Michigan providers must update billing procedures to include 'timely filing' in claim comments when submitting claims under retroactive eligibility exceptions (up to 6 months after eligibility determination for eligibility established within 12 months of service date). FQHCs, RHCs, and THCs must update billing systems to allow modifier 25 for significant E&M services on same day as procedures, in addition to existing modifier 59 usage. Update staff training on new Freedom to Work benefit plan (MA-FTW) coverage parameters.

Affected Billing Codes

59
25