MedicaidAdministrativeMedium impact
MSA 17-07
Michigan Medicaid - MDHHS·MI · Pharmacy·Provider Bulletin
Effective date
Apr 1, 2017
We identified it
Jun 20, 2026
Summary
Michigan Medicaid now requires providers to use modifier U6 on institutional and professional claims for drugs purchased through the 340B program, and enter value 20 in the Submission Clarification Code field for pharmacy claims. This replaces the previous requirement to contact MDHHS Drug Rebate Specialist directly.
Action Required
Before April 1, 2017: Billing team must update claim submission processes for 340B drugs - add modifier U6 to all institutional (837I/UB-04) and professional (837P/CMS-1500) drug claims, include 11-digit NDC with N4 qualifier, and enter value 20 in Submission Clarification Code field for pharmacy claims (NCPDP). Update billing software rules to automatically append U6 modifier for 340B purchased drugs. Failure to follow this process will result in claims being included in Medicaid drug rebate process and require reversing/resubmitting claims.