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Michigan Medicaid - MDHHSMedicaid · Billing Codes · Provider Bulletin · MIMedium impact

MSA 17-01

Effective date
Jan 1, 2017
Identified
Jun 20, 2026

Summary

Michigan Medicaid adopted the listed HCPCS and CPT codes for dates of service on and after January 1, 2017 for physicians, practitioners, medical clinics and other provider groups, and any new procedure code not listed will not be covered at this time, except for reporting codes. Codes marked with an asterisk require prior authorization, including 36473, 36474, 81327, J0570 and A4467. The bulletin also activates new coverage for codes 96931 through 96936 and 99487 for physicians and practitioners effective January 1, 2017, sets retroactive coverage for codes 92601 through 92604 for dates of service on and after October 1, 2016, end-dates J2502 for dates of service on and after October 1, 2016, and discontinues the listed 2015 codes effective December 31, 2016.

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What to do

Action · 4 steps
01Already effective January 1, 2017: Billing team: Get prior authorization for the codes marked with an asterisk, including 36473, 36474, 81327, J0570 and A4467.
02Billing team: New procedure codes not listed in this bulletin will not be covered at this time, except for reporting codes, which are optional and may complement Category I codes.
03Billing team: Place of service 02 (telehealth) is recognized for claims processed on or after January 1, 2017.
04Billing team: Discontinued codes listed in section F are discontinued effective December 31, 2016, and the retroactive coverage and end-dating items in sections C through E apply for dates of service on and after the dates stated in those sections.

Codes mentioned

364733647481327A4467J05709693196932969339693496935969369948792601926029260392604J2502

Original notice

MSA 17-01
michigan.gov · Always check the source before changing claims.
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Related changes

See all Michigan Medicaid - MDHHS changes →
MSA 20-53MediumEffective Jun 1, 2020 · Provider BulletinMSA 20-01MediumEffective Jan 1, 2020 · Provider BulletinMSA 20-25HighEffective Mar 1, 2020 · Provider BulletinMMP 23-27: End of the Federal Public Health Emergency and Unwinding of COVID-19 Response PoliciesMediumEffective May 11, 2023 · Provider BulletinBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesCode 36473Code 36474Code 81327Code A4467Code J0570Code 96931Code 96932Code 96933Code 96934Code 96935Code 96936Code 99487Code 92601Code 92602Code 92603Code 92604Code J2502

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