MedicaidBilling CodesMedium impact
MAB2022121302
Pennsylvania Medicaid (DHS)·PA · OB-GYN, Family Medicine, Pediatrics·Provider Bulletin
Effective date
Dec 25, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has added coverage for disposable breast milk collection bags (K1005 at $0.21 per bag, 120/month limit), increased fees for breast pump replacement supplies, and removed prior authorization requirements for electric breast pumps (E0603). Changes affect billing for maternal health supplies.
Action Required
Immediately: Update billing system to include new code K1005 for disposable breast milk collection bags with $0.21 fee and 120 per month limit. Update fees for codes A4281 ($15.91), A4282 ($22.70), and A4284 ($16.89). Remove prior authorization requirements for E0603 electric breast pumps. Applies only to Pennsylvania Medicaid fee-for-service patients.