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MedicaidBilling CodesMedium impact

MAB2021102101

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

Summary

FQHCs and RHCs must now use new zero-pay tracking codes G2215 (nasal naloxone) and G2216 (injectable naloxone) on separate claim lines when distributing take-home naloxone supplies to Medical Assistance beneficiaries. This allows the Department to track naloxone distribution while maintaining existing T1015 billing for the encounter.

Action Required

Action needed
Billing team at FQHCs and RHCs must update billing procedures to include appropriate zero-pay HCPCS codes G2215 or G2216 on separate claim lines when providing take-home naloxone supplies during T1015 encounters. Update billing system to automatically prompt for these tracking codes when naloxone distribution is documented.

Affected Billing Codes

T1015
G2215
G2216