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MedicaidBilling CodesMedium impact

MAB2022082601

Pennsylvania Medicaid (DHS)·PA · Psychiatry·Provider Bulletin
Effective date
Aug 26, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medicaid has expanded billing eligibility for psychiatric outpatient clinics and outpatient drug/alcohol clinics to bill evaluation and management codes (99202-99215). The policy also adds Naloxone tracking codes G2215/G2216 and transitions discontinued 99201 codes to 99241.

Action Required

Action needed
Immediately: Billing teams for psychiatric outpatient clinics and outpatient drug/alcohol clinics in Pennsylvania must update billing systems to allow E&M codes 99202-99215 for telemedicine and clinic settings. Replace discontinued 99201 codes with 99241 using appropriate modifiers (UB, U7, GT). Add G2215/G2216 as add-on codes when dispensing take-home Naloxone supplies. Update encounter forms and train staff on new provider type/place of service combinations.

Affected Billing Codes

99202
99203
99204
99205
99211
99212
99213
99214
99215
G2215
G2216
90792
90832
90834
90837
90846
90847
90853
90870
90875
96116
96121
96127
96130
96131
96132
96133
96136
96137
96160
99241
H0034
H2010
H0014
T1015
99201