Click here to go to the Infant Oral Health Training for Medical Providers Materials 

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:

  • Age restrictions,
  • Diagnoses allowable for Ambulance,
  • Documentation requirements,
  • Frequency limitations,
  • Hospital discharge – Bypass PA
  • NDC information,
  • Prior authorizations and medical conditions that may bypass these requirements,
  • Rate information,
  • Required modifiers,
  • Supplies/DME – per diem, and
  • Tooth number and surface requirements.

To request or view upcoming training sessions please refer to Michigan Department of Health and Human Services website at >> Communications and Training >> Medicaid Provider Training Sessions.

Any questions should be directed to Provider Inquiry, Michigan Department of Health and Human Services, phone toll-free 1-800-292-2550 or email at



                    Instructions (2012-2014)

Certified Nurse Midwife*
                   Instructions (2012-2014)

Oral Maxillofacial Surgeon 




                   Instructions (2012-2014)

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.


Physician Primary Care Rate Increase



                   Instructions (2012-2014)

Telemedicine Services







Drug Manufacturers with Signed Rebate Agreements with CMS 

Examples of NDC Billing for Practitioners 

Examples of NDC Billing for CMH