MedicaidBilling CodesMedium impact
MAB2023092901
Pennsylvania Medicaid (DHS)·PA · Family Medicine, General Practice, Internal Medicine +2 more·Provider Bulletin
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) is adding 10 new vaccine administration procedure codes to the fee schedule, effective October 1, 2023 and January 1, 2024. All new codes reimburse at $10.00 per administration with a limit of once per day.
Action Required
By October 1, 2023: Billing team must add new vaccine administration codes 90380, 90381, 90581, 90678, 90679, 90738, and 90758 to billing system for Pennsylvania Medicaid claims at $10.00 reimbursement rate with once-per-day limit. By January 1, 2024: Add codes 90589, 90623, and 90683. Update encounter forms to include new codes. For vaccines approved before January 1, 2024, use unlisted code 90749 until specific codes become active.