MedicaidCoverageMedium impact
MSA 17-12
Michigan Medicaid - MDHHS·MI · Pharmacy, Psychiatry·Provider Bulletin
Effective date
May 1, 2017
We identified it
Jun 20, 2026
Summary
Starting May 1, 2017, Michigan Medicaid allows pharmacy providers to bill for injectable drugs administered in residential treatment centers using NDC-based rates. Pharmacies must use proper Place of Service codes and avoid duplicate billing with practitioners.
Action Required
By May 1, 2017: Pharmacy providers must ensure proper Place of Service code is entered in NCPDP Patient Segment field 307-C7 for injectable drugs administered in residential treatment centers. Coordinate with practitioners to prevent duplicate billing - if practitioner purchases drug directly, they submit professional claim; if pharmacy acquires drug for administration, pharmacy submits pharmacy claim. Refer to current Pharmacy Claims Processing Manual at Michigan.fhsc.com for detailed submission requirements.