MedicaidBilling CodesMedium impact
MAB2023090101
Pennsylvania Medicaid (DHS)·PA · Family Medicine, OB-GYN, General Practice·Provider Bulletin
Effective date
Sep 5, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid updated the Family Planning Services Fee Schedule effective September 5, 2023, adding laboratory procedure code 87563 with FP modifier and expanding telehealth coverage for procedure code 96160 with FP modifier to include patient home settings (POS 10).
Action Required
By September 5, 2023: Billing team must update Pennsylvania Medicaid billing systems to include new laboratory code 87563 with FP modifier for family planning providers. Add telehealth POS code 10 (patient home) for procedure 96160 with FP modifier. Update fee schedules with new rates. Ensure all family planning services use FP modifier or appropriate ICD-10 diagnosis codes Z30.011 through Z30.9.