MedicaidBilling CodesMedium impact
MAB2022041801
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics·Provider Bulletin
Effective date
May 1, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has added two new procedure codes (T1019 and S9122) to the fee schedule for personal care services provided by home health agencies to beneficiaries under age 21. T1019 allows billing in 15-minute increments at $6.84 per unit, while S9122 allows hourly billing at $27.36 per unit.
Action Required
By May 1, 2022: Home health agencies must update billing systems to include new codes T1019 (15-minute increments, $6.84/unit, 96 units/day limit) and S9122 (hourly billing, $27.36/unit, 24 units/day limit) for personal care services to MA beneficiaries under age 21. Prior authorization required for both codes using MA97 form. Only one code can be used per calendar month. Ensure Electronic Visit Verification (EVV) compliance for both codes.