Claim Reprocessing Began with Pay Cycle 12 (Pay Date March 19)
By: Stephanie Davidson, MAC Insurance Director
MDHHS recently released the 2026 fee schedule update, and there are a few things you’ll need to be aware of, according to this MDHHS Provider Alert: Retro Rate Claim Adjustments.
The rates for CPT codes 98940–98942 decreased slightly, while some of the X-ray codes payable to chiropractors increased. Because of this, and the late release, MDHHS is automatically reprocessing fee-for-service claims dated January 1, 2026, and forward to bring payments in line with the updated rates. That reprocessing started with pay cycle 12 (pay date March 19) and is still ongoing.
When you’re reviewing remittances, you may see a claim note stating “CY26 RVU Rate Automation Retro Rate Adjustments”. Some of those will come through as recoupments or reductions on current claims for services that were already paid at the higher rate earlier this year.
The MAC Insurance Relations team recommends that offices:
- Monitor Medicaid remittance advices for adjustments in reimbursements
- Communicate with billing staff to ensure awareness of these adjustments
If you have questions regarding specific claims or the reprocessing of certain claims, MDHHS has directed providers to contact Provider Support at 1-800-292-2550 or ProviderSupport@Michigan.gov.
MAC Members: Check out the Medicaid section in the Doctor Resources section of the MAC website, www.chiromi.com. Included are:
- Michigan Medicaid Provider Manual (Version January 1, 2026)
- Michigan Medicaid Provider Manual – Chiropractic Section (January 1, 2026)
- Michigan Medicaid Beneficiary Co-Payment Requirements
- Michigan Medicaid Fee Schedule – January 2026 [NEW]
- Michigan Medicaid Fee Schedule – January 2025
- MDHHS Record-Keeping Email
