MedicaidBilling CodesHigh impact
MAB2023092001
Pennsylvania Medicaid (DHS)·PA · Pediatrics·Provider Bulletin
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is transitioning pediatric shift care services from personal care codes S9122/T1019 to home health aide code G0156 with modifiers U7 (non-LRR) or U7+SC (legally responsible relative), requiring Electronic Visit Verification (EVV) compliance. Old codes will be discontinued September 30, 2023, and new codes with EVV requirements begin October 1, 2023.
Action Required
By September 30, 2023: Stop billing codes S9122 and T1019 for pediatric shift care services. By October 1, 2023: Begin using G0156 with modifier U7 for non-legally responsible relatives or G0156 with modifiers U7 and SC for legally responsible relatives providing pediatric home health aide services to beneficiaries under 21. Billing team must implement EVV requirements per MA Bulletin 05-22-09 and update billing system to support new modifier combinations. Failure to transition will result in claim denials.