MedicaidCoverageMedium impact
MAB2022092301
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics, General Practice +2 more·Provider Bulletin
Effective date
Sep 23, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now covers COVID-19 vaccine counseling visits for beneficiaries under 21 when no vaccine is administered. Providers can bill CPT 99401 with modifier U2 at $10.00 per visit, limited to once per day.
Action Required
Immediately: Billing team must update system to allow CPT 99401 with modifier U2 for COVID-19 vaccine counseling visits for PA Medicaid beneficiaries under 21. Set fee at $10.00 and limit to once per day. Update encounter forms to include this option for qualified providers. Can be provided via telemedicine using Place of Service 02.