MedicaidBilling CodesHigh impact
MMP 25-26: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
Michigan Medicaid - MDHHS·MI·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has updated CPT and HCPCS codes effective July 1, 2025, adding new covered codes for various provider types and discontinuing several existing codes. This affects billing for Medicaid, Healthy Michigan Plan, and related programs in Michigan.
Action Required
By July 1, 2025: Billing team must update billing system to add new covered HCPCS codes (J0165, J0167, J0168, J0169, etc.) based on provider type and remove discontinued codes (Q2034-Q2039, J0171, J0173, etc.) from active billing lists. Set up prior authorization requirements for codes marked with asterisk (J3391, Q2058). Verify provider-specific code allowances match practice type. Claims using discontinued codes after June 30, 2025 will be denied.