MedicaidReimbursementHigh impact
MAB2024090902
Pennsylvania Medicaid (DHS)·PA · OB-GYN, Family Medicine, General Practice·Provider Bulletin
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) significantly increased reimbursement rates for family planning services, with some fees more than tripling. The increases are retroactive to July 1, 2024, and claims will be automatically reprocessed for higher payments.
Action Required
Immediately: Verify that Pennsylvania Medicaid claims for family planning services from July 1, 2024 forward are being billed with the FP modifier for affected codes. Review reprocessed claims payments for increases. Update fee schedules in billing system to reflect new rates. Ensure providers document family planning services appropriately to qualify for higher reimbursement rates.