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MedicaidBilling CodesMedium impact

MAB2022082901

Pennsylvania Medicaid (DHS)·PA · Family Medicine, General Practice, Internal Medicine·Provider Bulletin
Effective date
Aug 29, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medicaid updated billing procedures for FQHCs and RHCs distributing naloxone to patients. They must continue billing T1015 for payment but now use updated zero-pay tracking codes G1028, G2215, and G2216 on separate claim lines to track naloxone distribution.

Action Required

Action needed
Immediately: FQHCs and RHCs must update billing procedures to use new zero-pay HCPCS code G1028 and updated G2215 description for naloxone distribution tracking. Continue billing T1015 for payment, but add appropriate G-codes (G1028, G2215, or G2216) on separate claim lines for all encounters that include take-home naloxone supplies. Update billing system to include these tracking codes.

Affected Billing Codes

T1015
G1028
G2215
G2216