MedicaidCoverageHigh impact
MAB2022033101
Pennsylvania Medicaid (DHS)·PA · OB-GYN, Family Medicine, Internal Medicine +1 more·Provider Bulletin
Effective date
Apr 1, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is extending postpartum coverage from 60 days to 12 months effective April 1, 2022. This allows continuous coverage for postpartum mothers through the last day of the 12th month after pregnancy ends, with all services exempt from copayments.
Action Required
Immediately: Update billing system to recognize extended 12-month postpartum coverage for Pennsylvania Medicaid beneficiaries. Verify eligibility through EVS before rendering services. Remove copayment requirements for all services during the 12-month postpartum period. Train staff on new coverage timeline and documentation requirements for comprehensive postpartum care including chronic conditions, mental health screening, and family planning services.