MedicaidBilling CodesMedium impact
MAB2022070503
Pennsylvania Medicaid (DHS)·PA · Family Medicine, General Practice, Internal Medicine +2 more·Provider Bulletin
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) has added procedure code A4928 for disposable surgical masks to their fee schedule, allowing eligible providers to bill $19.96 per box of 20 masks with a limit of 2 boxes per month for beneficiaries ages 2-120. This new benefit is available for dates of service starting July 1, 2022.
Action Required
Immediately: Update billing system to include new HCPCS code A4928 for disposable surgical masks at $19.96 per box of 20. Configure system with quantity limits of 2 boxes per month and age restrictions (ages 2-120). Train eligible providers (physicians, physician assistants, nurse practitioners, podiatrists, and medical suppliers) on prescribing and dispensing requirements for Pennsylvania Medicaid beneficiaries.