MedicaidPrior AuthLow impact
MAB2021110402
Pennsylvania Medicaid (DHS)·PA · Psychiatry, Pediatrics, Neurology +2 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) updated prior authorization requirements for anxiolytic medications, adding catatonia as an approved diagnosis for patients under 21 years old. This expands access to benzodiazepines for pediatric patients with autism spectrum disorder per 2020 American Academy of Pediatrics guidelines.
Action Required
By January 3, 2022: Prescribers should update documentation to include catatonia as a qualifying diagnosis when prescribing anxiolytic benzodiazepines for Pennsylvania Medicaid patients under 21 years old. Billing teams should verify prior authorization guidelines are met and ensure prescribers are aware of the expanded diagnostic criteria for pediatric anxiolytic coverage.