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MAB2021073001

Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, General Practice +4 more·Provider Bulletin
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance (Medicaid) has expanded the types of providers who can bill for COVID-19 vaccine and monoclonal antibody administration. New eligible provider types include home health agencies, ambulance providers, renal dialysis centers, psychiatric outpatient clinics, drug and alcohol outpatient clinics, and partial psychiatric hospitals.

Action Required

Action needed
Immediately: Billing teams at newly eligible provider types (home health agencies, ambulance providers, renal dialysis centers, psychiatric outpatient clinics, drug and alcohol outpatient clinics, and partial psychiatric hospitals) in Pennsylvania should update their billing systems to include COVID-19 vaccine administration codes and monoclonal antibody therapy codes for Medical Assistance claims. Review Attachments A and B for specific billing procedures and fee schedules.

Affected Billing Codes

M0239
M0243
M0245
90471