Mailing addressMDHHS Program Review Division
PO Box 30170
Lansing, MI 48909
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Source: Medicaid Provider Manual Directory Appendix (version October 1, 2026). Fee-for-service PA for all services except hospital, specified DME, pharmacy and NEMT; also dental PA. Health plan enrollees: contact the Medicaid Health Plan.
Source: Medicaid Provider Manual Directory Appendix (version October 1, 2026). Program Review Division fax for FFS NEMT, FFS private duty nursing and NF complex care PA, and dental PA change requests.
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Service codes, requested dates and units
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