MedicaidReimbursementMedium impact
MAB2022061001
Pennsylvania Medicaid (DHS)·PA · Family Medicine, General Practice, Internal Medicine +1 more·Provider Bulletin
Effective date
Dec 1, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid implemented an alternative payment methodology for FQHCs and RHCs to receive standard fee schedule rates for COVID-19 vaccine-only visits and enhanced rates ($75) for homebound beneficiaries. This supersedes previous bulletin 08-20-66 and requires providers to opt-in within 30 days to receive these payment rates.
Action Required
By July 10, 2022: FQHCs and RHCs must email FinancialGatekeeper@pa.gov to opt-in to the alternative payment methodology, including 9-digit provider ID and 4-digit service location number. Use specific COVID vaccine administration codes and M0201 modifier for homebound patients. Future opt-ins require 10 business days advance notice.