MedicaidCoverageMedium impact
Prosthetics - MEDICAID - MICHIGAN (Revised)
Humana·MI · Orthopedics, Plastic Surgery, Ophthalmology +2 more·Medicaid
Effective date
Feb 11, 2026
We identified it
Jun 24, 2026
Summary
This is a revised Medicaid prosthetics policy for Michigan that establishes comprehensive coverage criteria for various prosthetic devices including upper/lower limb prostheses, eye prostheses, and specialized devices like osseointegrated prostheses. The policy provides detailed eligibility requirements and introduces coverage for newer technologies like enhanced dexterity prosthetic arms and multiarticulating myoelectric hands.
Action Required
Before February 11, 2026: Billing team must update prosthetics prior authorization workflows for Michigan Medicaid to include new coverage criteria for osseointegrated prostheses (age 22-65, specific medical conditions), enhanced dexterity prosthetic arms, and multiarticulating myoelectric hands. Update billing system to reflect new HCPCS codes and ensure documentation requirements for functional level assessments are captured. Review existing prosthetics cases to ensure compliance with revised criteria.