MedicaidCoverageMedium impact
MSA 17-09
Michigan Medicaid - MDHHS·MI · Pharmacy·Provider Bulletin
Effective date
Apr 1, 2017
We identified it
Jun 20, 2026
Summary
Michigan Medicaid is implementing new pharmacy reimbursement rates based on National Average Drug Acquisition Cost (NADAC) and introducing coverage for Medication Therapy Management (MTM) services provided by certified pharmacists. Professional dispensing fees will change to tiered rates ranging from $9.00 to $20.02 depending on drug type and preferred status.
Action Required
By April 1, 2017: Pharmacists providing MTM services must enroll in CHAMPS with Individual NPI as Rendering/Servicing-Only provider with Medication Therapy Management subspecialty. Complete APhA 'Delivering Medication Therapy Management Services' certificate training or approved equivalent. Update billing systems to reflect new professional dispensing fee structure: $20.02 for specialty drugs/compounds, $10.64 for non-PDL drugs, $10.80 for preferred PDL drugs, $9.00 for non-preferred PDL drugs. Ensure MTM documentation includes beneficiary consent, service details, and communication with primary care providers.