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HIPAA - Companion Guides

Michigan Medicaid utilizes the HIPAA compliant ASC X12 Version 5010 format for HIPAA transactions, except those with retail pharmacies. Pharmacy transactions must use the NCPDP standard. This standard applies to claims, payments, and enrollment electronic transactions. The manuals and guides listed below may assist providers and billing agents in creating and submitting electronic claims and in viewing electronic payment and enrollment files.

 Health Plans

 Questions regarding 834 and 820 files may be sent to:

Fee-for-Service (FFS)

 Additional 835 Information

 Questions regarding 835 and 837 files may be sent to:


Medicaid Encounter Technical Guidance

 Questions regarding Medicaid Encounter Technical Guidance may be sent to:

Medicaid Encounter Quality

 Questions regarding Medicaid Encounter Quality may be sent to:

BHDDA Encounter Guidance