MedicaidCoverageMedium impact
MAB2022060601
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Family Medicine, General Practice·Provider Bulletin
Effective date
Jun 6, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid updated the Blood Lead Reference Value from 5 μg/dL to 3.5 μg/dL for children under 21, requiring Environmental Lead Investigation (ELI) referrals at the lower threshold. ELI provider qualification requirements were also simplified by removing the nurse/sanitarian contracting requirement.
Action Required
Immediately: Providers must refer MA beneficiaries under 21 years of age for Environmental Lead Investigation (ELI) when blood lead levels are ≥3.5 μg/dL (previously 5 μg/dL). Update clinical protocols and EMR templates to reflect the new 3.5 μg/dL threshold for ELI referrals. Ensure all blood lead testing follows required schedule: 12 months, 24 months, and between 36-72 months if not previously tested.