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MedicaidBilling CodesMedium impact

MAB2020100101

Pennsylvania Medicaid (DHS)·PA · Pharmacy·Provider Bulletin
Effective date
Oct 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Effective October 1, 2020, Pennsylvania Medical Assistance (Medicaid) will reimburse pharmacies $10 for COVID-19 specimen collection by licensed pharmacists using new procedure code G2023. Pharmacies must add Provider Specialty Type 247 (Pharmacist) to their existing provider enrollment and cannot bill for both specimen collection and testing services.

Action Required

Action needed
Immediately: Pennsylvania pharmacies must complete a PROMISe Provider Service Location Change Request to add Provider Specialty Type 247 (Pharmacist) to their existing provider enrollment. Update billing system to use procedure code G2023 for COVID-19 specimen collection with $10 reimbursement rate, limit 1 per day, Place of Service 11. Include ordering practitioner's NPI on all claims and identify pharmacy as rendering/billing provider.

Affected Billing Codes

G2023