MedicaidReimbursementHigh impact
MMP 26-40: Portable X-ray Suppliers Rate Update
Michigan Medicaid - MDHHS·MI · Radiology·Claims & Billing
Effective date
Oct 1, 2026
We identified it
Sep 16, 2026
Summary
Michigan Medicaid updates reimbursement rates for portable x-ray suppliers effective October 1, 2026. HCPCS codes R0070 and R0075 will now be reimbursed at 72.25% of the Medicare annual rate. Billing teams must implement new HCPCS Level II modifiers (UN, UP, UQ, UR, US) to indicate the number of individuals served during each trip, as reimbursement is calculated based on individuals served regardless of payer.
Action Required
By September 30, 2026: Billing team must update all billing software and claim submission processes to implement HCPCS Level II modifiers for portable x-ray services. Specifically: (1) Configure system to append modifier UN when two individuals are served, UP for three, UQ for four, UR for five, and US for six or more individuals during a single trip; (2) Update claim submission logic to report the base code (R0070 or R0075) alone when only one individual is served; (3) Train billing staff on proper modifier application based on number of individuals served per trip; (4) Verify that the new reimbursement rate of 72.25% of Medicare annual rate is entered into fee schedules for R0070 and R0075; (5) Contact portable x-ray suppliers in network to ensure they understand the new modifier requirements. Failure to apply modifiers correctly will result in claim denials or underpayment. Implementation is contingent on CMS approval of the State Plan Amendment.