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September 22 2022 Medical Suppliers Billing External Ambulatory Insulin Infusion Pumps E0784

September 22, 2022: Attention Medical Suppliers: Michigan Medicaid covers external ambulatory insulin infusion pumps (HCPCS E0784) as a purchase-only item, unless the beneficiary has primary insurance that covers the pump as a rental item and the provider is billing for coinsurance and/or deductible following the primary insurance payment. Payment for the coinsurance/deductible is subject to Medicaid allowable limits. Submitting claims for E0784 to Medicaid as a rental (when there is no primary insurance) is incorrect billing. Michigan Department of Health and Human Services (MDHHS) will perform post payment recoveries for incorrectly billed claims.

To review billing, coordination of benefits and external infusion (insulin) pump policy requirements refer to the Medicaid Provider Manual: www.michigan.gov/medicaidproviders >> Policy, Letters & Forms >> Medicaid Provider Manual.