MedicaidBilling CodesMedium impact
MAB2023110201
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, OB-GYN +2 more·Provider Bulletin
Effective date
Dec 1, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance will cover at-home STI test kits starting December 1, 2023, using new A9999 procedure codes with specific U3-U8 modifiers. Different fee structures apply for pharmacy pickup versus laboratory direct mail distribution.
Action Required
Before December 1, 2023: Billing team must add new A9999 codes with modifiers U3, U4, U5 (for pharmacies) and U6, U7, U8 (for laboratories) to billing system for Pennsylvania Medicaid STI test kits. Update fee schedules with rates ranging from $66.00 to $189.00. Ensure test kits are FDA-cleared for at-home specimen collection before billing.