MedicaidBilling CodesMedium impact
MAB2020050102
Pennsylvania Medicaid (DHS)·PA · Pulmonology, Critical Care, Internal Medicine +1 more·Provider Bulletin
Effective date
Mar 1, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has added procedure code E0467 (Multi-Function Ventilator) to their fee schedule effective March 1, 2020, paying $1051.90 monthly rental with required prior authorization. This was implemented as a COVID-19 emergency response to increase access to home ventilators.
Action Required
Medical suppliers: Update billing system to include HCPCS code E0467 with RR modifier for multi-function ventilator rentals at $1051.90/month for Pennsylvania Medicaid patients. Ensure prior authorization is obtained before billing E0467. For backup ventilators, submit PE requests through the 1150 Administrative Waiver process.