MedicaidCoverageMedium impact
MSA 16-26
Michigan Medicaid - MDHHS·MI · ENT (Ear, Nose & Throat)·Provider Bulletin
Effective date
Oct 1, 2016
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has activated coverage for CPT code 69220 effective October 1, 2016, and updated Third Party Liability (TPL) policies requiring providers to bill automobile insurance and workers' compensation before billing Medicaid or Medicaid managed care plans.
Action Required
By October 1, 2016: Billing team must update system to allow billing of CPT code 69220 for physicians, practitioners and medical clinic providers under Michigan Medicaid programs. Ensure all automobile insurance and workers' compensation claims are billed and exhausted before billing Medicaid or Medicaid managed care plans, as billing Medicaid first may be considered fraud under the Medicaid False Claim Act.