Clinical Laboratory

Person doing work in laboratory



Refer to the Practitioner Fee Schedule for laboratory services allowable for practitioners and medical clinics.

The 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 Health and Human Services website at >>Communications and Training>>Medicaid Provider Training Sessions.

Any questions should be directed to Provider Inquiry, phone toll-free 800-292-2550 or email at


NOTE:   The information contained in the January 2007 MDHHS Clinical Lab Database for PT 40 is valid only for DOS on or before March 31, 2007.  Effective April 1, 2007 PT 40 laboratory services will be reimbursed under the MDHHS Outpatient Prospective Payment System (OPPS) using Medicare's lab fee schedule for Michigan, applying multi-chanel/panel pricing and the MDHHS reduction factor (RF).  Type 40 providers should refer to the OPPS Wrap Around Code List and the Revenue Code Requirement Table for additional information. Please refer to the Outpatient Hospital provider web page for additional information and reference.