MedicaidCoverageMedium impact
MAB2021072902
Pennsylvania Medicaid (DHS)·PA · Nephrology, Psychiatry, Family Medicine +1 more·Provider Bulletin
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) has expanded the list of provider types eligible to bill for COVID-19 vaccine and monoclonal antibody administration. New eligible providers include home health agencies, ambulance providers, renal dialysis centers, psychiatric outpatient clinics, drug/alcohol outpatient clinics, and partial psychiatric hospitals.
Action Required
Immediately: Providers in the newly eligible categories (home health agencies, ambulance providers, renal dialysis centers, psychiatric outpatient clinics, drug/alcohol outpatient clinics, partial psychiatric hospitals) should verify their Medical Assistance enrollment status and begin billing for COVID-19 vaccine administration using CPT codes 0001A and related codes. Renal dialysis centers can now also bill for monoclonal antibody therapy using CPT codes M0239, M0243, and M0245. Update billing systems to reflect these expanded provider eligibilities for Pennsylvania Medicaid claims.