MedicaidBilling CodesMedium impact
MAB2020120201
Pennsylvania Medicaid (DHS)·PA · Dentistry, Oral & Maxillofacial Surgery·Provider Bulletin
Effective date
May 26, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) updated their dental fee schedule effective May 26, 2020, adding new procedure codes D1551, D1552, D1553, D1556, D1557, D1558, D8703, D8704 and end-dating codes D1550 and D1555. The updated fee schedule includes specific reimbursement rates, service limits, and prior authorization requirements for dental procedures.
Action Required
Immediately: Billing team must update Pennsylvania Medicaid dental billing to use new codes D1551-D1558, D8703-D8704 and stop using end-dated codes D1550 and D1555 for dates of service on/after May 26, 2020. Update billing system with the specific fee schedule rates and service limits provided in the attached schedule. Note that FQHCs and RHCs should continue billing T1015 with U9 modifier for dental services.