The Michigan Department of Health and Human Services (MDHHS) recently released two concurrent final and proposed policies to implement Medicaid rate increases included in the fiscal year (FY) 2023 budget for dates of service on and after Oct. 1, 2022. These include:
- 2235-Practitioner proposes to update rates for physician neonatal and pediatric critical and intensive care services for certain current procedural terminology (CPT) codes from 95% to 100% of Medicare rates. Members are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 7, 2022.
- 2234-Practitioner proposes to increase Medicaid rates for primary care services for CPT codes 99421 through 99423 and 99441 through 99443. The MDHHS indicates rates for the applicable CPT codes will increase from roughly 75% of Medicare to 88% of Medicare. These CPT codes include:
- Established patient office or outpatient evaluation and management (E/M) visits.
- Initial subsequent, discharge and other nursing facility E/M visits.
- New and established patient domiciliary, rest home or custodial care E/M services.
- New and established patient home E/M visits.
- New and established patient preventive medicine services.
- Online digital E/M services and E/M services provided via telephone.
Members are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 9, 2022.
Members with questions should contact Vickie Kunz at the MHA.