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

The following new professional fee schedule format 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 Community Health website at >> 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


Certified Nurse Midwife 










**  Drug Manufacturers with Signed Rebate Agreements with CMS 

*** Examples of NDC Billing for Practitioners 

Examples of NDC Billing for CMH 




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