MedicaidCoverageMedium impact
Skin and Tissue Substitutes - MEDICAID - MICHIGAN (Revised)
Humana·MI · Wound Care, Podiatry, General Surgery +4 more·Medicaid
Effective date
Jun 5, 2026
We identified it
Jun 24, 2026
Summary
Michigan Medicaid has revised its policy for skin and tissue substitutes, effective June 5, 2026. Coverage is limited to specific diabetic foot ulcers and chronic venous leg ulcers over 4 weeks duration when used with comprehensive standard wound therapy, with strict documentation requirements for all criteria.
Action Required
Before June 5, 2026: Billing team must update documentation requirements for Michigan Medicaid skin substitute claims using Q4xxx codes. Ensure all diabetic foot ulcer and venous leg ulcer claims include complete documentation of wound duration >4 weeks, comprehensive assessment, standard wound therapy compliance, infection treatment, and glycemic management. Create documentation checklist for providers. Claims missing any required criteria will be denied as not medically necessary.