MedicaidCoverageMedium impact
MAB2021062401
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Family Medicine, General Practice·Provider Bulletin
Effective date
Mar 1, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania updated its EPSDT (Early and Periodic Screening, Diagnosis and Treatment) periodicity schedule to add hepatitis C virus (HCV) risk assessment and screening for ages 18-20. The updated schedule and coding matrix is effective March 1, 2021, and includes new footnote requirements for annual HCV reassessment for high-risk individuals.
Action Required
By March 1, 2021: Providers must use the updated Pennsylvania EPSDT Program Periodicity Schedule and Coding Matrix when providing and billing EPSDT screens. Update clinical protocols to include HCV risk assessment at ages 18, 19, and 20, with annual reassessment for high-risk individuals including those with past or current injection drug use. Review complete coding matrix to ensure all age-appropriate screening codes are being used correctly.