MedicaidAdministrativeMedium impact
MAB2026131901
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, General Practice +3 more·Provider Bulletin
Effective date
Apr 18, 2026
We identified it
Jun 20, 2026
Summary
Starting April 18, 2026, certified Community Health Workers (CHWs) can enroll in Pennsylvania's Medical Assistance Program as Provider Type 13 with specialty code 139 to provide services to Medicaid managed care members. CHWs must be certified by the Pennsylvania Certification Board and can provide up to 3 encounters per year when recommended by enrolled physicians for patients with chronic conditions like diabetes, hypertension, or asthma.
Action Required
By April 18, 2026: Providers who may recommend CHW services (physicians, physician assistants, certified nurse practitioners, certified nurse midwives) should familiarize themselves with the new CHW enrollment process and identify eligible patients with chronic conditions (asthma, COPD, diabetes, heart disease, hypercholesterolemia, hypertension, obesity, or multiple medications) who could benefit from CHW services. Contact your Medicaid managed care organization for coverage and payment details regarding CHW services.