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MedicaidBilling CodesMedium impact

MAB2021113001

Pennsylvania Medicaid (DHS)·PA · Dentistry·Provider Bulletin
Effective date
Aug 23, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance updated their dental fee schedule effective August 23, 2021, adding 9 new procedure codes (D1321, D3471, D3472, D3473, D3501, D3502, D3503, D7961, D7962) and removing code D7960. This affects dentists billing Pennsylvania Medicaid for fee-for-service patients.

Action Required

Action needed
Billing team must update fee schedules and billing systems to include new procedure codes D1321, D3471, D3472, D3473, D3501, D3502, D3503, D7961, D7962 and stop using end-dated code D7960 for Pennsylvania Medicaid claims with dates of service on/after August 23, 2021. Note that counseling codes D1320 and D1321 cannot be billed for the same beneficiary on the same date of service.

Affected Billing Codes

D1321
D3471
D3472
D3473
D3501
D3502
D3503
D7961
D7962
D7960
T1015
99407
D1320
D0120
D0140
D0145
D0150
D0210
D0220
D0230
D0240
D0250
D0251
D0270
D0272
D0273
D0274
D0330
D0340
D1110
D1120
D1206
D1208
D1351
D1354
D1510
D1516
D1517
D1551
D1552
D1553
D1556