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MedicaidAdministrativeMedium impact

MAB2024012401

Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics, Internal Medicine +2 more·Provider Bulletin
Effective date
Jan 24, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance (Medicaid) has issued a new Vaccine Desk Reference containing CPT codes for vaccine administration billing. The reference consolidates all covered vaccine codes into one resource and will be updated when new codes are added to the fee schedule.

Action Required

Action needed
Immediately: Billing team should bookmark the new PA Medical Assistance Vaccine Desk Reference at https://www.dhs.pa.gov/providers/Providers/Pages/Medical-Assistance-for-Providers.aspx for vaccine billing reference. Verify that vaccine administration billing uses only the CPT codes listed in the desk reference. Update billing procedures to check this reference when new vaccine codes are added to ensure compliance with PA Medicaid requirements.

Affected Billing Codes

90380
90381
90581
90585
90587
90589
90611
90619
90620
90621
90622
90623
90625
90626
90627
90630
90632
90633
90636
90647
90648
90651
90656
90662
90670
90671
90672
90674
90675
90677
90678
90679
90680
90681
90682
90683
90685
90686
90687
90688
90691
90696
90697
90698
90700
90702
90707
90710
90713
90714
90715
90716
90717
90723
90732