MedicaidAdministrativeLow impact
MAB2025052101
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Family Medicine, General Practice·Provider Bulletin
Effective date
May 21, 2025
We identified it
Jun 20, 2026
Summary
Pennsylvania updated its EPSDT (Early and Periodic Screening, Diagnosis and Treatment) periodicity schedule with a minor change to fluoride varnish guidance. The only change is updated language for Footnote 26 regarding fluoride varnish application for children up to 21 years using procedure code 99188.
Action Required
Immediately: Review Footnote 26 language for fluoride varnish procedures. Primary care providers should note that fluoride varnish may be applied every 3-6 months for children up to 21 years and billed using procedure code 99188. Update any internal documentation or encounter forms to reflect this clarification if needed.