The following new professional fee schedule format for 2015 and forward (noted below with *) lists procedure codes, descriptions, and fee screens. The modifier and age range fields are applicable to the fee screen and do not reflect coverage parameters. For additional pertinent coverage parameters, such as documentation and billing indicators, refer to the Medicaid Code and Rate Reference tool, which is accessible via the External Links menu within CHAMPS. Medicaid Code and Rate Reference is an online code inquiry system that provides real-time information for the following:
Diagnoses allowable for Ambulance,
Hospital discharge – Bypass PA
Prior authorizations and medical conditions that may bypass these requirements,
Supplies/DME – per diem, and
Tooth number and surface requirements.
To request or view upcoming training sessions please refer to Michigan Department of Community Health website at www.michigan.gov/medicaidproviders >> Communications and Training >> Medicaid Provider Training Sessions.
Any questions should be directed to Provider Inquiry, Department of Community Health, phone toll-free 800-292-2550 or email at firstname.lastname@example.org.
Physician Administered Drugs and Biologicals (ARCHIVE ONLY) For databases January 2015 and newer, refer to the Practitioner Fee Schedule for physician administered drugs and biologicals allowable for practitioners and medical clinics. Instructions