Clinical Laboratory
 


 

   

 

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

The 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 www.Michigan.gov/medicaidproviders >>Training>>Medicaid Provider Trainings.

Any questions should be directed to Provider Inquiry, phone toll-free 800-292-2550 or email at providersupport@michigan.gov.

 

NOTE:   Rate information contained in the MDHHS Clinical Laboratory Database is valid for Independent Clinical Laboratories only. Outpatient Hospital laboratory services are reimbursed under the MDHHS Outpatient Prospective Payment System (OPPS). Outpatient Hospital laboratory providers should refer to the Outpatient Hospital provider web page for additional information and reference.