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MedicaidReimbursementMedium impact

MAB2023012601

Pennsylvania Medicaid (DHS)·PA · Emergency Medicine·Provider Bulletin
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance (Medicaid) has increased reimbursement rates for ambulance services effective January 1, 2023. Basic life support rates increased from $180 to $325, advanced life support from $300 to $400, and ground mileage beyond 20 miles doubled from $2 to $4 per mile.

Action Required

Action needed
Immediately: Billing team must update fee schedules in billing system to reflect new Pennsylvania Medicaid rates for ambulance codes A0425, A0426, A0427, A0428, A0429, A0433, and A0434 effective January 1, 2023. Verify system is using updated MA Program Outpatient Fee Schedule from Pennsylvania DHS website. For managed care MA plans, contact individual MCOs for billing guidance.

Affected Billing Codes

A0425
A0426
A0427
A0428
A0429
A0433
A0434