MedicaidCoverageMedium impact
mab2025120202
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics, OB-GYN +2 more·Provider Bulletin
Effective date
Dec 2, 2025
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance program now covers all evidence-based vaccines recommended by AAP, AAFP, and ACOG in addition to ACIP recommendations, expanding immunization coverage beyond federal guidelines. This policy replaces previous guidance that only followed ACIP recommendations.
Action Required
Immediately: Update billing procedures to include vaccines recommended by AAP, AAFP, and ACOG that may not be on ACIP schedules. Review current vaccine administration billing to ensure all evidence-based vaccines from these organizations are being billed to PA Medicaid. Verify vaccine coverage using the provided immunization schedule links from each organization.