MedicaidBilling CodesMedium impact
MAB2022021401
Pennsylvania Medicaid (DHS)·PA · Psychiatry, Pain Management·Provider Bulletin
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now covers community-based care management services provided by Centers of Excellence for Opioid Use Disorders using new billing code G9012, reimbursed at $46.20 per service. This applies only to providers enrolled with specialty code 232 serving patients with opioid use disorders.
Action Required
For providers enrolled as Opioid Centers of Excellence (specialty 232): Update billing system to include HCPCS code G9012 for community-based care management services at $46.20 reimbursement rate. Ensure billing is limited to once per day and includes appropriate place of service codes. Non-COE providers: No action required as this only applies to specialty enrollment 232.