MedicaidBilling CodesMedium impact
MAB2022082902
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Infectious Disease +1 more·Provider Bulletin
Effective date
Jul 26, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) has added three new billing codes for monkeypox testing and vaccination effective July 26, 2022. The policy adds CPT codes 87593 for orthopoxvirus testing, 90611 for smallpox/monkeypox vaccine, and 90622 for vaccinia vaccine with specific fees and billing limitations.
Action Required
Immediately: Billing team must update fee schedules in billing system to include CPT codes 87593 ($39.77), 90611 ($10), and 90622 ($10) for Pennsylvania Medicaid patients. Configure system limits: 87593 limited to one test per day, 90611 and 90622 limited to once per day. Update encounter forms to include these codes for providers treating monkeypox. Note: Do not bill for vaccines received at no cost or when paid by another entity.