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MedicaidBilling CodesMedium impact

MAB2021063001

Pennsylvania Medicaid (DHS)·PA · Orthopedics, Urology, Anesthesiology +4 more·Provider Bulletin
Effective date
Dec 21, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance (Medicaid) updated their fee schedule effective December 21, 2020, adding new procedure codes, end-dating obsolete vaccine codes, and modifying provider type/specialty/place of service combinations for various procedures including orthopedic, vascular, and psychiatric services.

Action Required

Action needed
By December 21, 2021: Billing team must stop using end-dated vaccine codes (90634, 90649, 90650, 90654, 90655, 90657, 90658, 90660, 90661, 90673, 90676, 90682, 90690, 90733, 90748) for Pennsylvania Medicaid claims. Update billing system to include new procedure codes (29893, 60650, 81221, 81222, 81223, 90662, 96136, 96137) with appropriate modifiers. Verify provider type/specialty/place of service combinations are correct for affected procedures in billing software. Update quantity limits for medical supply codes per new monthly limits.

Affected Billing Codes

29893
60650
81221
81222
81223
90662
96136
96137
90634
90649
90650
90654
90655
90657
90658
90660
90661
90673
90676
90682
90690
90733
90748
36245
36246
36247
50389
64420
64421
00212
00214
00222
01150
01214
01432
01952
01953
27130
43281
63267
81528
92081
92082
92083
90791
90792
90832
90834
90837
90846
90847
90875
96116
96121
96127
96130
96131
96132
96133
96160
H2010
95813
A6223
A6266
E0956
E1028
A6209
A6210
A6211
A6212
A6213
A6214
A6224
A4624
A6206
A6207
A6208
A6222