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MedicaidReimbursementMedium impact

MSA 16-03

Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Jan 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid updated the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) reduction factor from 52.5% to 52.6% following public comments. This affects reimbursement calculations for outpatient services under Michigan Medicaid programs.

Action Required

Action needed
Effective January 1, 2016: Billing team must update Michigan Medicaid reimbursement calculations to reflect the new 52.6% reduction factor for OPPS and ASC services (increased from 52.5%). Update billing software settings for Michigan Medicaid, Children's Special Health Care Services, and MOMS programs to ensure accurate payment expectations.