MedicaidBilling CodesMedium impact
MSA 17-34
Michigan Medicaid - MDHHS·MI · Pediatrics, Family Medicine·Provider Bulletin
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
Medicaid updated EPSDT screening requirements for children under 21 based on new AAP guidelines, including enhanced vision/hearing screenings, depression screening for ages 12+, maternal depression screening, and HIV/STI risk assessments starting at age 11. Billing code changes: CDT D1206 ended November 30, 2017, replaced by CPT 99188 for fluoride varnish application, and CPT 96161 can be billed for maternal depression screening.
Action Required
By January 1, 2018: Update billing system to use CPT 99188 instead of CDT D1206 for fluoride varnish applications by PCPs. Add CPT 96161 for maternal depression screening (bill under infant's Medicaid ID). Update encounter forms to include new screening requirements: depression screening annually for ages 12+, HIV/STI risk assessments starting at age 11, and enhanced vision/hearing protocols per AAP periodicity schedule.