MedicaidBilling CodesMedium impact
MAB2022091401
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Aug 29, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) added 6 new adult vaccine CPT codes to their fee schedule and expanded shingles vaccine coverage to include immunocompromised adults ages 18-49. All new vaccines reimburse at $10.00 per administration with a limit of once per day.
Action Required
Billing team must update PA Medicaid billing system to include new vaccine codes 90587, 90626, 90627, 90671, 90677 with $10.00 reimbursement rate and once-per-day limit. Update age range for CPT 90750 (shingles vaccine) to allow billing for immunocompromised patients ages 18-49. Verify proper provider type and place of service codes are configured for each vaccine per the attached fee schedule.