MedicaidPrior AuthMedium impact
MAB2023110701
Pennsylvania Medicaid (DHS)·PA · Endocrinology, Family Medicine, Internal Medicine +1 more·Provider Bulletin
Effective date
Jan 8, 2024
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is updating prior authorization requirements for androgenic agents (testosterone and related hormones) effective January 8, 2024. The main change is updating references to current transgender health standards, but all existing prior authorization requirements remain the same.
Action Required
By January 8, 2024: Review current prior authorization procedures for androgenic agents to ensure compliance with updated guidelines. Verify that requests for testosterone and related hormones include required documentation: clinical/lab findings for hypogonadism, endocrinologist involvement for gender dysphoria cases, and therapeutic failure documentation for non-preferred agents. No system changes required as authorization requirements remain unchanged.