The Michigan no-fault fee schedule rose 16.38% for dates of service between July 2, 2026 and July 1, 2027. That is the figure in Bulletin 2026-09-INS, issued by the Department of Insurance and Financial Services on February 25, 2026, and it applies to the amounts payable that were in effect on January 1, 2019 under MCL 500.3157(7) or (8). For a practice treating auto injury patients in Michigan, three facts decide what a claim pays: the date of the accident, whether Medicare publishes an amount for the service, and which category the practice falls into. Everything else, including the arguments, follows from having those three recorded on the day the patient first walks in.
In short
- 16.38% on January 1, 2019 amounts, for dates of service July 2, 2026 to July 1, 2027 (DIFS Bulletin 2026-09-INS, 2026).
- That figure is last year's cumulative 13.12% plus this year's 2.88%, tracking the medical care component of the Consumer Price Index.
- Where Medicare publishes an amount, the cap for most providers is 190% of Medicare for treatment rendered after July 1, 2023 (MCL 500.3157(2)(c)).
- Family or household attendant care in the home is limited to 56 hours a week (MCL 500.3157(10), MCL 418.315(1)).
The categories, as the statute writes them
MCL 500.3157 sets a different ceiling depending on who renders the treatment. For treatment rendered after July 1, 2023, the percentages stopped stepping down and now hold.
| Who renders the treatment | Cap where Medicare publishes an amount | Cap where it does not |
|---|---|---|
| Most physicians, hospitals and clinics | 190% of Medicare | 52.5% of the January 1, 2019 charge description master |
| 20% to under 30% indigent volume, or a designated freestanding rehabilitation facility | 220% of Medicare | 66.5% |
| 30% or more indigent volume | 250% of Medicare | 78% |
| Level I or II trauma centre, emergency care before the patient is stabilised | 230% of Medicare | 71% |
The right-hand column is where the bulletin lands. Those 2019 figures, and only those, carry the annual Consumer Price Index adjustment, now cumulatively 16.38%. The left-hand column moves for a different reason: under MCL 500.3157(8), a change in the amount payable under Medicare flows through to the allowed amount, though the result may not exceed the average amount the provider charged for that treatment on January 1, 2019.
Three rules sit alongside the percentages and are easy to miss. A neurological rehabilitation clinic is not entitled to payment at all unless it is accredited by the Commission on Accreditation of Rehabilitation Facilities or a similar organisation recognised by the director (MCL 500.3157(12)). Emergency medical services rendered by an ambulance operation are outside subsections (2) to (12) entirely (MCL 500.3157(13)). And the whole scheme applies to treatment rendered after July 1, 2021 (MCL 500.3157(14)).
The date of the accident decides which law applies
In Andary v USAA Casualty Insurance Company, decided on July 31, 2023, the Michigan Supreme Court held that MCL 500.3157(7) and MCL 500.3157(10), the non-Medicare fee schedule and the family attendant care limit, do not apply to the cost of treatment for people injured in motor vehicle accidents occurring before June 11, 2019.
For a practice, that is not a legal abstraction. It means two patients on the same schedule, with the same injury and the same treatment, can be paid under two different regimes, and the only thing distinguishing them is the accident date recorded at intake. If your intake form captures the claim number and the adjuster but not the accident date, the office cannot tell which patient is which without calling someone.
Six things the office should hold on every no-fault claim
- The accident date, in a field, not a note. It decides whether the fee schedule applies at all.
- The claim number, insurer and adjuster, with a date of last contact. The adjuster changes more often than the patient does.
- Which category the practice falls into. Most practices are the first row of the table. If yours qualifies under the indigent volume provisions, MCL 500.3157(5) requires documents to be supplied to the director and certification each year.
- The January 1, 2019 charge, per service. For anything Medicare does not price, the 2019 figure is the base that this year's 16.38% is applied to. That number lives in your own records, and it is worth finding once rather than each time.
- A log of what was sent and when. Records, bills, reports, the attendant care documentation. With dates, not "sent."
- A list of what the adjuster asked for and has not received. This is the part that decides whether a file moves this month.
The mistake most offices make at step 5
They treat the file as complete when the claim is submitted. On a no-fault claim, the exchange continues for months, and the question that comes back is rarely "was this billed correctly." It is "where is the report from the visit on the 14th." An office that keeps a running list of what has been sent, what has been asked for and what is outstanding answers that in one message. An office that reconstructs it from an inbox spends an afternoon.
What we build for this
For Michigan practices treating auto injury patients, the no-fault packet on our healthcare page tracks each claim: what has been sent, what the adjuster asked for and what is missing, as status. It is operational documentation, not a legal determination, and it never makes a coding decision or decides what a service is worth. Your billing staff and your counsel do that. The system keeps the record straight and surfaces the gap while it can still be closed.
The percentage of Medicare in the left-hand column also moves when Medicare itself moves. The 2027 physician fee schedule check covers what CMS proposed for next year and the code-level review worth running before the final rule.
The fee schedule changes every July. The three dates on the file are what make that change easy to apply, or expensive to argue about.
