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Michigan Medicaid - MDHHSMedicaid · Billing Codes · Claims & Billing · MI · Family Medicine, Internal Medicine, Pediatrics +7 moreHigh impact

MMP 26-03: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Effective date
Jan 1, 2026
Identified
Jun 16, 2026

Summary

Michigan Medicaid bulletin MMP 26-03 adopts CPT and HCPCS code changes for Medicaid, Healthy Michigan Plan, Children's Special Health Care Services, Maternity Outpatient Medical Services and MI Coordinated Health programs. Changes effective for dates of service on and after January 1, 2026 include stand-alone vaccine counseling reported under CPT 90482-90484, hearing aid services reported under CPT 92636-92639, psychiatric Collaborative Care Model services reported under CPT 99492-99494 and HCPCS G2214, and activated coverage for CPT 15011-15018 and HCPCS J0681. Coverage of several codes, including V5011, V5020 and G0310-G0315, ended December 31, 2025, and those dates have passed as of the analysis date of 2026-11-05, so this is and current applicability should be checked before acting.

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What to do

Action · 6 steps
01Historical bulletin with effective dates that have passed: check current applicability before acting.
02Billing team: for dates of service on and after January 1, 2026, non-pharmacy providers report CPT 90482-90484 for stand-alone vaccine counseling when no vaccine is administered on the same date of service, and the counseling requires documentation of at least three minutes of counseling time, in person or by telehealth.
03Billing team: FQHCs, RHCs and THCs report Collaborative Care Model services with CPT 99492, 99493 and 99494 and HCPCS G2214 instead of G0512, which was end-dated December 31, 2025.
04Billing team: hearing aid providers report follow-up fitting and checking under CPT 92636 and 92637, and conformity evaluation under CPT 92638 and/or 92639 instead of V5011 and V5020, which Medicaid no longer covers after December 31, 2025.
05Billing team: stop billing the discontinued codes listed in section H, effective December 31, 2025, and check the Medicaid Code and Rate Reference tool in CHAMPS for age restrictions, prior authorization requirements and other billing indicators.
06Billing team: report MiDPP asynchronous online behavioral counseling under HCPCS G9871 and follow DPRP standards and Michigan Medicaid telemedicine policy.

Codes mentioned

90482904839048492636926379263892639994929949399494G2214G0512V5011V5020G0310G0315G98711501115012150131501415015150161501715018J0681G0311G0312G0313G0314G3015

Original notice

MMP 26-03: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
michigan.gov · Always check the source before changing claims.
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