MedicaidReimbursementMedium impact
MAB2022022402
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 MA Program Fee Schedule rates for COVID-19 vaccine administration during vaccine-only visits, with enhanced payments for homebound beneficiaries. Providers must opt-in to this payment method by emailing the state within 30 days of this bulletin.
Action Required
By March 26, 2022: FQHCs and RHCs must email FinancialGatekeeper@pa.gov with provider ID and service location numbers to opt-in to the alternative payment methodology for COVID-19 vaccine administration. Include both 9-digit provider ID and 4-digit service location number. Use specific COVID-19 vaccine administration codes (0001A, 0002A, 0011A, 0012A, 0031A, 0003A, 00013A) and add M0201 code for homebound beneficiaries after June 8, 2021.