lJFgLlPvyQe5fX}ucMZ 7ThM~bI8_)#Xf+B:)V2Z/S3X*2Y,( endobj endobj 5 0 obj Thank you for participating in the Michigan Medicaid Program. Share sensitive information only on official, secure websites. <>>> . Information on child support services for participants and partners. Information about injury and violence prevention programs in Michigan. <> New Therapy Chapter PDF Michigan NCPDP D.0 Payer Specifications - Magellan Rx Management endobj 13 0 obj A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. . Medicaid Code and Rate Reference Tool 96-Non-covered charge(s). Information about the Michigan law that requires certain information be made available to a woman who is seeking an abortion at least 24 hours prior to the abortion procedure. Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, cancer, chronic obstructive pulmonary . Michigan Medicaid Provider Manual >>>> Billing and Reimbursement for Dental Providers >> Section 5.2- Under the demonstration, Michigan and CMS will contract with health plans called Integrated Care Organizations (ICOs), which will . 14 0 obj J6l"L. The tool is housed in CHAMPS within the External Links function. <>/F 4/A<>>> RW Imp Guide: Required, if known, when patient has Medicaid . Medicaid Code and Rate Reference Tool . Rendering Provider not associated with Billing Provider in CHAMPS Review the rendering provider's enrollment information to make sure the NPI is associated to the group NPI in CHAMPS for the DOS. % . 5 0 obj Michigan Regions For Medicare Quick and Easy Solution <> Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. D 3"dsxQg?8aIHHH9:-. zmr|.OUlK:o`!.`*R.z,wfG|9~&D6+=a+M%[Gf'CYN9S.tcZTb]!KLv,9P2 /BQ!auPAE{(Tt':_4t2s. 6?BLJ 8(;6vhL Our migrant program works with a number of organizations to provide services for Michigans migrant and seasonal farmworkers. Effective for dates of service on and after September 1, 2019, the Michigan Department of endobj % Ohio - Wikipedia Michigan | Medicaid A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. endobj 18 0 obj Michigan Medicaid uses the terms "telemedicine" and "telepractice". 1 0 obj Licensing information for Adult Foster Care and Homes for the Aged, Child Day Care Facilities, Child Caring Institutions, Children's Foster Care Homes, Child Placing Agencies, Juvenile Court Operated Facilities and Children's or Adult Foster Care Camps. Issued: October 1, 2019 (Proposed) Heres how you know. Birth, Death, Marriage and Divorce Records. Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. Health Link Model. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 15 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 4. <> 3 0 obj Medicaid Code and Rate Reference is an online code inquiry system that provides real-time information for the following: Age restrictions, Adult Behavioral Health & Developmental Disability Services. Health Care Coverage information and resources. CMS is releasing the2022-2023 Medicaid Managed Care Rate Development Guidefor states to use when setting rates with respect to any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2022 and June 30, 2023. Programs Affected: Medicaid, Healthy Michigan Plan, Children's Special Health Care Services, Maternity Outpatient Medical Services . endstream endobj The managed care regulation requires that states develop valid managed care capitation rates in accordance with generally accepted actuarial principles and practices. DB101 Michigan - How Health Benefits Work: SSI-Related Medicaid oW~G\y^y"]&gasklV[rOd$P&(}sS"Oo. CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical . A variety of reports & statistics for programs and services. The guide provides detail around CMS' expectations of information to be included in actuarial rate certifications, and the guide will be used as a basis for CMS review. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> <> <> 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. <> We update the Code List to conform to the most recent publications of CPT and HCPCS codes and to account for changes in Medicare coverage and payment policies. On April 3, 2014, the Centers for Medicare & Medicaid Services (CMS) announced a new partnership with the State of Michigan to test an initiative to improve care for Medicare-Medicaid enrollees. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing . <> Information on resources in your community and volunteer recruitment and training, and services provided at local DHS offices. ul`^c{eDPVg!Z'e$2?FLPE~Oye_]P*}W@!xyOR*! `#Mk8|&vq The professional fee schedule format lists procedure codes, descriptions, and fee screens. endobj endobj 3mMZ*b0_KK E^s^~|^"3z` I3XI~3&at98K?i|2^^p%P\+,&|"8OF! ;KE9 r*/v!k0e@l{nPu*D=bmYQ1d:B[oc6Ab. A locked padlock Programs for healthy children & families, including immunization, lead poisoning prevention, prenatal smoking cessation, and many others. 2022-2023 Medicaid Managed Care Rate Development Guide CMS is releasing the 2022-2023 Medicaid Managed Care Rate Development Guide (PDF, 567.27 KB) for states to use when setting rates with respect to any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2022 and June 30, 2023. Information on assistance with home repairs, heat and utility bills, relocation, home ownership, burials, home energy, and eligibility requirements. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 960 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> [ 12 0 R] %PDF-1.7 Medicaid Code and Rate Reference - 2/09/18 www.Michigan.gov . Information on the Children's Foster Care program and becoming a Foster Parent. <>/Metadata 535 0 R/ViewerPreferences 536 0 R>> For help utilizing this tool reference the below resources: Quick . . <> Michigan Medicaid fee schedules are updated every January. The term chronic is often applied when the course of the disease lasts for more than three months. endobj Issued: April 1, 2019 Subject: Update to the Coverage of Certified Nurse Midwife Services Effective: May 1, 2019 Programs Affected: Medicaid, Healthy Michigan Plan, Maternity Outpatient Medical PDF Medicaid Code Add Title and Rate Reference Tool - Michigan A lock ( For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces . To request or view upcoming training sessions, please refer to Michigan Department of Community Health xf{ a8 YdD@ '[Mb90BB $[Uwu3Z3=l!B!B!B!B!B!B{>/OU{[}z_:Xzr{oTWWwz5,j~L'?+J/?={BK+Cu~7%B"Uz$IR^9NOUOW]'Mvp+J/?uofk j +rXPr{oTWt3grnO;j~LDy?:!{4$~ 4 0 obj All meetings will be held from 1:00 PM - 2:30 PM via conference call and Microsoft Teams. 6 0 obj Low-income Households Water Assistance Program (LIHWAP). A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. stream The Michigan Domestic & Sexual Violence Prevention and Treatment Board administers state and federal funding for domestic violence shelters and advocacy services, develops and recommends policy, and develops and provides technical assistance and training. Medicaid Code and Rate Reference tool within the Community Health Automated Medicaid Processing System (CHAMPS) at https://sso.state.mi.us >> External Links >> Medicaid Code and Rate Reference. Michigan | CMS - Centers for Medicare & Medicaid Services Information on adoption programs, adoption resources, locating birth parents and obtaining information from adoption records. For additional pertinent coverage parameters, such as documentation and billing indicators, refer to the Medicaid Code and Rate Reference tool, which is accessible via the External Links menu within CHAMPS. endobj <> xMk09e 4iBhvcCM4mFqvwi4;3VrWbV`|a3@2A+2~&[X\Y[NE} ux*SS (mEewx{)]~PZ HDdJvnoua&H&p~n/.`0WS(]z?mdF'dR&2M{\hu0Fhm2*hHLvsXhC 0FP%$R%,;k+SP=94t1@|+2odi{@+Ty? Benefit plan data is assigned by the CHAMPS Eligibility and Enrollment (EE) Subsystem based on the source of the data (e.g., Medicaid, CSHCS, etc.) endobj <> An official website of the United States government xf{ a8 YdD@ '[Mb90BB $[Uwu3Z3=l!B!B!B!B!B!B{>/OU{[}z_:Xzr{oTWWwz5,j~L'?+J/?={BK+Cu~7%B"Uz$IR^9NOUOW]'Mvp+J/?uofk j +rXPr{oTWt3grnO;j~LDy?:!{4$~ oW~G\y^y"]&gasklV[rOd$P&(}sS"Oo. Distribution: Federally Qualified Health Centers, Rural Health Clinics, Tribal Health Centers, Medicaid Health Plans, Community Mental Health Services Programs, Prepaid Inpatient Health Plans, Integrated Care Organizations . Child Welfare Medical and Behavioral Health Resources. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. The supplemental information will be available real-time by accessing the Medicaid Code and Rate Reference tool. Call Medicare 1-800-633-4227; Call MMAP, Inc. 1-800-803-7174 ; Work Preparation. TE4L"Fui)(w60I$zgP Gu69E3Dgf/7,R,$Q!X`[T9@59z(ZPVCt IY!`y5^|v#ix kuSRf&zI#& &n7SJK> Information on American Indian Services, Employment and Training. If you live alone, try this tool to see if your countable income is below SSI-related Medicaid's income limit. 4 0 obj stream A .gov website belongs to an official government organization in the United States. 7 0 obj endobj Healthy Kids Dental - HKD benefit plan covers, at a minimum, all codes on the MDHHS Dental Fee Schedule. rasR7w9=cvqgR^)Y[h1:^CjFzcG GK<>"ts309czIj(Vgq(yYPYa]Kk`$$m Please direct any questions related to this guide toMMCratesetting@cms.hhs.gov. 2 0 obj *We only collect and arrange information about third-party websites for your reference. Before penicillin was introduced in the 1940s, syphilis plagued U.S. soldiers. xOKP|L__`[G endobj Beginning as early as January 2015, many of the currently posted databases may be revised to include code and rate information only. MI Public Health Code states that certain individuals are not required to have a license for practice of a health profession in MI, including the following: . Benefit Plans - MI Health Plan Benefits Michigan Agreement to Maintain and Service Medical Equipment US Legal Forms provides state-specific forms and templates in Word and PDF format that you can instantly download, complete, and print. endobj 9 0 obj information about the Department's public safety programs. According to the Michigan Department of Health and Human Services, the rate of primary and secondary syphilis in women has increased substantially across the United States; 21% from 2019-2020 and 147% from 2016 through 2020. Prescription/Service Reference Number Qualifier (455-EM) is "1" 42-D2 PRESCRIPTION/SERVICE REFERENCE NUMBER x]!dbIU|)vc;NqmE.o@g!3GGK2Cs ?Szz\d!IHH#0KGBB0Y;`[j$$$_Vnlk%x~1# Z"D ] V!uYuc%@o x!oEd(bGSmNh'nsy)J D"h*Aw#j p'|ft Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. Medicaid Code and Rate Reference Tool. A federal government managed website by theCenters for Medicare & Medicaid Services.7500 Security Boulevard Baltimore, MD 21244, An official website of the United States government, Improving Care for Medicaid Beneficiaries with Complex Care Needs and High Costs, Promoting Community Integration Through Long-Term Services and Supports, Eligibility & Administration SPA Implementation Guides, Medicaid Data Collection Tool (MDCT) Portal, Using Section 1115 Demonstrations for Disaster Response, Home & Community-Based Services in Public Health Emergencies, Unwinding and Returning to Regular Operations after COVID-19, Medicaid and CHIP Eligibility & Enrollment Webinars, Affordable Care Act Program Integrity Provisions, Medicaid and CHIP Quality Resource Library, Lawfully Residing Immigrant Children & Pregnant Women, Home & Community Based Services Authorities, July 2022 Medicaid & CHIP Enrollment Data Highlights, Medicaid Enrollment Data Collected Through MBES, Performance Indicator Technical Assistance, 1115 Demonstration Monitoring & Evaluation, 1115 Substance Use Disorder Demonstrations, Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations, Medicaid and CHIP Managed Care Final Rules, Seniors & Medicare and Medicaid Enrollees, Medicaid Third Party Liability & Coordination of Benefits, Medicaid Eligibility Quality Control Program, State Budget & Expenditure Reporting for Medicaid and CHIP, CMS-64 FFCRA Increased FMAP Expenditure Data, Actuarial Report on the Financial Outlook for Medicaid, Section 223 Demonstration Program to Improve Community Mental Health Services, Medicaid Information Technology Architecture, Medicaid Enterprise Certification Toolkit, Medicaid Eligibility & Enrollment Toolkit, SUPPORT Act Innovative State Initiatives and Strategies, SUPPORT Act Provider Capacity Demonstration, State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services, Early and Periodic Screening, Diagnostic, and Treatment, Vision and Hearing Screening Services for Children and Adolescents, Alternatives to Psychiatric Residential Treatment Facilities Demonstration, Testing Experience & Functional Tools demonstration, Medicaid MAGI & CHIP Application Processing Time, 2022-2023 Medicaid Managed Care Rate Development Guide, 2021-2022 Medicaid Managed Care Rate Development Guide, 2020-2021 Medicaid Managed Care Rate Development Guide, 2019-2020 Medicaid Managed Care Rate Development Guide, 2018-2019 Medicaid Managed Care Rate Development Guide, 2017-2018 Medicaid Managed Care Rate Development Guide, 2017 Managed Care Rate Setting Consultation Guide, Addendum to 2016 Medicaid Managed Care Rate Development Guide, 2016 Managed Care Rate Setting Consultation Guide, 2015 Managed Care Rate Setting Consultation Guide, 2014 Managed Care Rate Setting Consultation Guide. <> 3 0 obj endobj Other Insurance (OI) - search.michigan.gov Michigan Medicaid NCPDP D.0 Payer Specifications August 30, 2021 . 9 0 obj stream 8 0 obj 1 0 obj 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. endobj Program Contact 1-800-803-7174 Additional Info Apply for Michigan Medicaid Managing Agency U.S. Department of Health and Human Services Checkif you may be eligible for this benefit Your community and volunteer recruitment and training, and durable Medical, & | '' 8OF programs services! 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