Summary
Michigan Medicaid completed its October 2017 update to the Medicaid Provider Manual, with the online manual available October 1, 2017. The update adds Medicaid coverage of HCPCS codes Q9984, Q9985, Q9986, Q9989 and C9498 for dates of service on and after July 1, 2017, and C9498 requires prior authorization, while coverage of C9487, J1725, P9072, 90649, 90650 and 90748 was discontinued effective June 30, 2017. The update also includes changes to ambulance mileage reporting, preventive services coding with modifier 33, and many technical clarifications across other chapters.
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What to do
Action · 6 steps
01Already effective June 30, 2017: Medicaid discontinued coverage of C9487, J1725, P9072, 90649, 90650 and 90748.
02Already effective for dates of service on and after July 1, 2017: Medicaid covers Q9984, Q9985, Q9986 and Q9989 for physicians, nurse practitioners, medical clinics and outpatient hospitals; Q9986 and Q9989 for ambulatory surgical centers; Q9984, Q9985 and Q9986 for certified nurse midwives; and Q9984 for family planning clinics.
03C9498 requires prior authorization for ambulatory surgical centers and outpatient hospitals, so obtain prior authorization before billing it for those providers.
04Add modifier 33 to a service whose primary purpose is delivery of an evidence-based service with a USPSTF grade A or B rating, and do not use modifier 33 on separately reported services specifically identified as preventive.
05For school based services, procedure codes 99367 and G9008 that replicate the services of other billed codes will not be reimbursed for the same date of service.
06Ambulance providers must report mileage in whole miles for trips totaling 100 miles or more, and for trips totaling less than 100 miles must report mileage rounded up to the nearest tenth of a mile.
Codes mentioned
Q9984Q9985Q9986Q9989C9498C9487J1725P907290649906509074899367G9008
Original notice
MSA 17-30
michigan.gov · Always check the source before changing claims.
Related changes
See all Michigan Medicaid - MDHHS changes →MMP 26-31: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2026 · Claims & BillingMSA 17-01MediumEffective Jan 1, 2017 · Provider BulletinMSA 18-16MediumEffective Jul 1, 2018 · Provider BulletinMSA 18-32MediumEffective Oct 1, 2018 · Provider BulletinBrowse every Michigan Medicaid - MDHHS change in the policy list