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MedicaidAdministrativeHigh impact

MSA 17-10

Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Jul 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan FQHCs, RHCs, and THCs must switch from professional (CMS-1500) to institutional billing format (UB-04) for Medicaid claims. Claims using the old professional format will be denied after the effective date.

Action Required

Action needed
By July 1, 2017: Michigan FQHCs, RHCs, and THCs must update billing systems to submit claims using ASC X12N 837 5010 institutional format instead of professional format. Use Type of Bill 77x for FQHC/THC and 71x for RHC. Include all same-day services on one claim with detailed HCPCS coding and appropriate clinic payment codes. Claims submitted in professional format after this date will be denied.

Affected Billing Codes

G0466
G0467
G0468
G0469
G0470
T1015
59425
59426