MedicaidCoverageMedium impact
Neurostimulators - MEDICAID - MICHIGAN (New)
Humana·MI · Neurology, Neurosurgery·Medicaid
Effective date
Jun 17, 2026
We identified it
Jun 24, 2026
Summary
New Medicaid policy in Michigan establishes coverage criteria for neurostimulator devices and electrodes for drug-resistant epilepsy. The policy covers implantation, removal, and replacement of skull-mounted cranial neurostimulators with specific eligibility requirements including age 18+, averaging 3+ disabling seizures per month, and failure of 2+ antiepileptic medications.
Action Required
Before June 17, 2026: Billing team must update prior authorization protocols for neurostimulator procedures (CPT 61860, 61863, 61867, 61889, 61891, 61892) for Michigan Medicaid patients. Create documentation checklist to verify eligibility criteria including age 18+, 3+ monthly seizures, failure of 2+ antiepileptic drugs, and contraindication screening. Update encounter forms to capture required clinical documentation for approval.