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Pennsylvania Medicaid (DHS)Medicaid · Billing Codes · Provider Bulletin · PA · PsychiatryMedium impact

MAB2022082601

Act
immediately
Effective date
Aug 26, 2022
Identified
Jun 20, 2026

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.

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What to do

immediately · 4 steps
01Billing 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.
02Replace discontinued 99201 codes with 99241 using appropriate modifiers (UB, U7, GT).
03Add G2215/G2216 as add-on codes when dispensing take-home Naloxone supplies.
04Update encounter forms and train staff on new provider type/place of service combinations.

Codes mentioned

992029920399204992059921199212992139921499215G2215G22169079290832908349083790846908479085390870908759611696121961279613096131961329613396136961379616099241H0034H2010H0014T101599201

Original notice

MAB2022082601
pa.gov · Always check the source before changing claims.
View original ↗

Related changes

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MAB2021063001MediumEffective Dec 21, 2020 · Provider BulletinMAB2021082001MediumEffective Aug 23, 2021 · Provider BulletinMAB2023060101MediumEffective Jun 1, 2023 · Provider BulletinMAB2024052802MediumEffective May 28, 2024 · Provider BulletinBrowse every Pennsylvania Medicaid (DHS) change in the policy list

Related policy hubs

Pennsylvania Medicaid (DHS) policiesPA policy changesPsychiatryCode 99202Code 99203Code 99204Code 99205Code 99211Code 99212Code 99213Code 99214Code 99215Code G2215Code G2216Code 90792Code 90832Code 90834Code 90837Code 90846Code 90847Code 90853Code 90870Code 90875Code 96116Code 96121Code 96127Code 96130Code 96131Code 96132Code 96133Code 96136Code 96137Code 96160Code 99241Code H0034Code H2010Code H0014Code T1015Code 99201

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MAB2022082601 | Pennsylvania Medicaid (DHS)