MedicaidBilling CodesHigh impact
MAB2023091101
Pennsylvania Medicaid (DHS)·PA · Pediatrics·Provider Bulletin
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is replacing personal care service codes S9122 and T1019 with home health aide code G0156 with new modifiers for beneficiaries under 21. New modifiers distinguish between services provided by legally responsible relatives versus non-relatives, with different billing requirements for each.
Action Required
By October 1, 2023: Home health agencies must stop billing codes S9122 and T1019 for pediatric personal care services. Begin using G0156 with modifier U7 for non-legally responsible relatives, or G0156 with modifiers U7 and SC for legally responsible relatives. Update billing system to ensure U7 modifier is listed first on claims. All services require prior authorization and are limited to 96 units per day for ages 0-20.