Molina Healthcare Michigan policy

Procedure to Place of Service Policy, Professional

Procedure to Place of Service Policy, Professional is a public Molina Healthcare Michigan policy. It lists 247 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

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Payer
Molina Healthcare Michigan
Line of business
Medicaid
States
MI
Source
www.molinahealthcare.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.

CodeOther Molina Healthcare Michigan policies
0001APolicies naming 0001A
0002APolicies naming 0002A
0003APolicies naming 0003A
0004APolicies naming 0004A
0011APolicies naming 0011A
0012APolicies naming 0012A
0013APolicies naming 0013A
0031APolicies naming 0031A
0034APolicies naming 0034A
0051APolicies naming 0051A
0052APolicies naming 0052A
0053APolicies naming 0053A
0054APolicies naming 0054A
0064APolicies naming 0064A
0071APolicies naming 0071A
0072APolicies naming 0072A
0073APolicies naming 0073A
0074APolicies naming 0074A
0081APolicies naming 0081A
0082APolicies naming 0082A
0083APolicies naming 0083A
0094APolicies naming 0094A
0104APolicies naming 0104A
0111APolicies naming 0111A
0112APolicies naming 0112A
30468Policies naming 30468
36415Policies naming 36415
59000Policies naming 59000
59025Policies naming 59025
71271Policies naming 71271
75574Policies naming 75574
76145Policies naming 76145
76946Policies naming 76946
80050Policies naming 80050
80143Policies naming 80143
80151Policies naming 80151
80161Policies naming 80161
80167Policies naming 80167
80179Policies naming 80179
80181Policies naming 80181
80189Policies naming 80189
80193Policies naming 80193
80204Policies naming 80204
80210Policies naming 80210
80306Policies naming 80306
80307Policies naming 80307
81000Policies naming 81000
81002Policies naming 81002
81025Policies naming 81025
82077Policies naming 82077
82681Policies naming 82681
82948Policies naming 82948
90377Policies naming 90377
90480Policies naming 90480
90785Policies naming 90785
90791Policies naming 90791
90792Policies naming 90792
90832Policies naming 90832
90833Policies naming 90833
90834Policies naming 90834
90836Policies naming 90836
90837Policies naming 90837
90838Policies naming 90838
90846Policies naming 90846
90847Policies naming 90847
90849Policies naming 90849
90853Policies naming 90853
91300Policies naming 91300
91303Policies naming 91303
91304Policies naming 91304
91305Policies naming 91305
91311Policies naming 91311
91318Policies naming 91318
91319Policies naming 91319
91320Policies naming 91320
91321Policies naming 91321
91322Policies naming 91322
92229Policies naming 92229
92650Policies naming 92650
92651Policies naming 92651
92652Policies naming 92652
92653Policies naming 92653
94619Policies naming 94619
94640Policies naming 94640
96116Policies naming 96116
96121Policies naming 96121
96130Policies naming 96130
96131Policies naming 96131
96132Policies naming 96132
96133Policies naming 96133
96136Policies naming 96136
96137Policies naming 96137
96138Policies naming 96138
96139Policies naming 96139
96164Policies naming 96164
96165Policies naming 96165
96167Policies naming 96167
96168Policies naming 96168
96170Policies naming 96170
96171Policies naming 96171
96372Policies naming 96372
97001Policies naming 97001
97546Policies naming 97546
98966Policies naming 98966
98967Policies naming 98967
98968Policies naming 98968
99000Policies naming 99000
99001Policies naming 99001
99050Policies naming 99050
99051Policies naming 99051
99056Policies naming 99056
99075Policies naming 99075
99201Policies naming 99201
99202Policies naming 99202
99203Policies naming 99203
99204Policies naming 99204
99205Policies naming 99205
99211Policies naming 99211
99212Policies naming 99212
99213Policies naming 99213
99214Policies naming 99214
99215Policies naming 99215
99217Policies naming 99217
99220Policies naming 99220
99255Policies naming 99255
99304Policies naming 99304
99305Policies naming 99305
99306Policies naming 99306
99307Policies naming 99307
99308Policies naming 99308
99309Policies naming 99309
99310Policies naming 99310
99318Policies naming 99318
99324Policies naming 99324
99328Policies naming 99328
99334Policies naming 99334
99337Policies naming 99337
99341Policies naming 99341
99342Policies naming 99342
99344Policies naming 99344
99345Policies naming 99345
99347Policies naming 99347
99348Policies naming 99348
99349Policies naming 99349
99350Policies naming 99350
99354Policies naming 99354
99355Policies naming 99355
99421Policies naming 99421
99422Policies naming 99422
99423Policies naming 99423
99451Policies naming 99451
99483Policies naming 99483
99499Policies naming 99499
G0071Policies naming G0071
G0151Policies naming G0151
G0152Policies naming G0152
G0153Policies naming G0153
G0398Policies naming G0398
G0399Policies naming G0399
G0400Policies naming G0400
G0410Policies naming G0410
G0411Policies naming G0411
G0495Policies naming G0495
G0511Policies naming G0511
G0512Policies naming G0512
G2012Policies naming G2012
G2067Policies naming G2067
G2080Policies naming G2080
G2081Policies naming G2081
G2105Policies naming G2105
G9898Policies naming G9898
G9901Policies naming G9901
G9910Policies naming G9910
G9938Policies naming G9938
H0001Policies naming H0001
H0004Policies naming H0004
H0010Policies naming H0010
H0011Policies naming H0011
H0012Policies naming H0012
H0015Policies naming H0015
H0016Policies naming H0016
H0017Policies naming H0017
H0020Policies naming H0020
H0023Policies naming H0023
H0025Policies naming H0025
H0026Policies naming H0026
H0030Policies naming H0030
H0031Policies naming H0031
H0032Policies naming H0032
H0033Policies naming H0033
H0034Policies naming H0034
H0035Policies naming H0035
H0036Policies naming H0036
H0038Policies naming H0038
H0040Policies naming H0040
H0043Policies naming H0043
H0045Policies naming H0045
H0046Policies naming H0046
H0047Policies naming H0047
H0050Policies naming H0050
H2011Policies naming H2011
H2012Policies naming H2012
H2014Policies naming H2014
H2015Policies naming H2015
H2017Policies naming H2017
H2021Policies naming H2021
H2022Policies naming H2022
H2023Policies naming H2023
H2025Policies naming H2025
H2027Policies naming H2027
H2028Policies naming H2028
H2031Policies naming H2031
H2033Policies naming H2033
H2036Policies naming H2036
J0879Policies naming J0879
J1640Policies naming J1640
J1823Policies naming J1823
L8699Policies naming L8699
M0201Policies naming M0201
M0220Policies naming M0220
M0221Policies naming M0221
M1284Policies naming M1284
M1285Policies naming M1285
Q4081Policies naming Q4081
Q5002Policies naming Q5002
R0070Policies naming R0070
R0075Policies naming R0075
S0013Policies naming S0013
S0109Policies naming S0109
S0260Policies naming S0260
S9122Policies naming S9122
S9125Policies naming S9125
S9446Policies naming S9446
S9480Policies naming S9480
S9484Policies naming S9484
S9485Policies naming S9485
T1001Policies naming T1001
T1002Policies naming T1002
T1003Policies naming T1003
T1013Policies naming T1013
T1015Policies naming T1015
T1016Policies naming T1016
T1023Policies naming T1023
T2038Policies naming T2038
T2042Policies naming T2042
T2043Policies naming T2043
T2048Policies naming T2048

All Molina Healthcare Michigan policies · Molina Healthcare Michigan prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.