MedicaidBilling CodesMedium impact
MAB2024052802
Pennsylvania Medicaid (DHS)·PA · Family Medicine, OB-GYN·Provider Bulletin
Effective date
May 28, 2024
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance added new procedure code G0136 for social determinants of health risk assessment (5-15 minutes) to the Family Planning Services Program fee schedule, effective May 28, 2024. This code can be billed by multiple provider types including physicians, nurse practitioners, physician assistants, and certified nurse midwives in various settings including telehealth.
Action Required
Immediately: Billing teams at family planning providers in Pennsylvania should update their billing systems to include new HCPCS code G0136 with FP modifier for social determinants of health risk assessments. Verify provider type and place of service combinations are correctly configured per the updated Family Planning Services Covered Services Chart. Review and implement the updated Family Planning Covered Drugs and Devices Chart for services rendered on or after May 28, 2024.