MedicaidBilling CodesMedium impact
MAB2021072901
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Summary
Medical Assistance (Medicaid) will now provide enhanced payment for COVID-19 vaccine administration to homebound beneficiaries. Providers must use specific billing codes and modifiers: AT modifier with POS 12 for services April 1-June 7, 2021, and add CPT code M0201 starting June 8, 2021.
Action Required
Immediately: Update billing system to use AT modifier with POS 12 (Home) for COVID-19 vaccine administration codes 0001A, 0002A, 0011A, 0012A, 0031A when administered to homebound Medicaid beneficiaries from April 1-June 7, 2021. For dates June 8, 2021 and after, add CPT code M0201 along with applicable vaccine administration code. Train billing staff on homebound patient criteria and enhanced payment requirements.