MedicaidBilling CodesMedium impact
MAB2023122701
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid will now cover and pay for interprofessional consultation services between providers starting January 1, 2024. This allows billing for provider-to-provider consultations when the patient is not present, using new CPT codes 99446-99452 with specific time-based billing requirements.
Action Required
By January 1, 2024: Billing team must add new CPT codes 99446-99452 to billing system for Pennsylvania Medicaid interprofessional consultations. Update fee schedules with specified rates ($14.01-$42.30). Train providers on 14-day restriction rules and documentation requirements for verbal and written reports. Ensure proper place of service codes are used (not POS 02 or 10).