MedicaidBilling CodesMedium impact
MAB2022111002
Pennsylvania Medicaid (DHS)·PA · Pharmacy·Provider Bulletin
Effective date
Dec 5, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is changing the billing code for over-the-counter COVID-19 tests from T1999 to K1034, effective December 5, 2022. The new code K1034 has a payment rate of $11.51 per test with a limit of 8 tests per month for enrolled pharmacies.
Action Required
By December 5, 2022: Pharmacy billing teams must stop using procedure code T1999 and begin using K1034 for all over-the-counter COVID-19 tests provided to Pennsylvania Medicaid beneficiaries. Update billing systems to reflect the new $11.51 payment rate and enforce the 8 tests per month limit. Code T1999 will be end-dated December 4, 2022.