Key takeaways:
- Personal care NPIs: replace the generic 1111111111 with your ISD NPI when the signing clinician has no individual NPI.
- By 7/1/2027, rendering providers need an individual NPI, and Medicaid-eligible providers must be enrolled in state Medicaid to stay on the RMTS Staff Pool List and reimbursable.
- Old modifiers are a common cause of N519 denials, and the bulletin includes a modifier checklist.
- Quick hits on coordination of care and specialized transportation.
The Inside Scoop: What Michigan Districts Are Seeing
Twice a year, our Relay Michigan Medicaid expert teams up with Michigan partner districts for a focused working session. We go over the latest state updates, compare what everyone is seeing in claims and denials, and talk through what each means for individual teams. While the sessions are open only to Relay clients, we've gathered all the insights in one place for anyone to see, with the action items first.
What’s Inside
✅ A to-do list sorted by timing. What to update now, what to start before 7/1/2027, and what to keep checking.
✅ The personal care NPI update. What to replace if the clinician signing the authorization has no individual NPI.
✅ The road to 7/1/2027. Individual NPIs and state Medicaid enrollment, with the steps and typical timing for each.
✅ A modifier checklist. Some ISDs are seeing more N519 denials, and old modifiers are a common cause. The bulletin lists the modifiers to check and what to do if a claim still denies.
It’s a short read, and the dates in it are worth having on your calendar.
